Cardiac Surgery in Pregnancy
Cenk Eray Yıldız
Keywords: Cardiac surgery, cardiopulmonary bypass, pregnancy.
Cardiovascular applications during pregnancy can be tolerated among pregnant women. However, about 2-4% of women at gestational age have concomitant heart disease. A few of these patients may undergo corrective surgery. In this state, maternal mortality rates are improved so that the rates will be similar to that of non-pregnant patients undergoing the same treatment. However fetal mortality rates are high (35%). The factors that lead to high fetal mortality are the timing of operation, emergency of the operation and fetal/fetoplacental response towards cardiopulmonary bypass. The adjustment of this response may prevent placental dysfunction and uterin contractions. These contractions are the main reason of hypoxia and acidosis. In this article, cardiovascular applications during pregnacy and the effects of cardiovascular bypass on the mother, fetus and fetoplacental unit have been discussed and also manipulations of these responses whether improved the fetal outcome. As a result, perfusion management and off-pump cardiac surgical techniques during pregnancy have been assessed.