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Cardiovascular surgery in the parturient

Denial Smith

No obstetric mortality in pregnancy is mostly caused by heart disease, which affects 1%–3% of pregnancies and accounts for 10%–15% of maternal fatalities. Congenital heart disease has grown more common in women of reproductive age, accounting for a growing percentage of heart disease in women (up to 75 percent) during pregnancy. The fetus is also at danger if the mother's heart illness is not managed. A maternal New York Heart Association score is an independent predictor of neonatal problems. Anti-coagulation usage during pregnancy is associated with heart failure classification 2 Smoking, numerous pregnancies, and a blocked left heart Because the parturient cardiac surgical morbidity and mortality is greater than that of no pregnant patients, most parturient with heart illness are treated medically first, with cardiac surgery reserved for when medical treatment fails. The use of vasoactive medications, age, type of surgery, reoperation, and maternal functional class are all risk factors for maternal death following heart surgery. Maternal age of 35 years, functional class, reoperation, emergency surgery, type of myocardial protection, and anoxic duration are all risk factors for fetus death. Nonetheless, acceptable maternal and fetal perioperative death rates can be attained by taking steps like detecting maternal cardiovascular decompensation early in the pregnancy, using fetal monitoring, delivering a healthy fetus before surgery, and scheduling surgery on an elective basis during the second trimester of pregnancy.

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