Perioperative Considerations of the Obstetric Patient with Heart Disease

Abstract

This review summarizes perioperative anesthetic considerations for obstetric patients undergoing non-obstetric surgery, with a focus on cardiac surgery and interventional cardiology procedures. In general, current evidence supports managing pregnant patients similarly to non-pregnant patients when medically indicated. A patient’s pregnant state should not impede necessary surgery, interventions, or medications. Anesthetic agents used at standard concentrations are not associated with teratogenicity, and moderate sedation is an acceptable option for pregnancy termination in high-risk cardiac patients at early gestations. Obstetric patients presenting for cardiac procedures require multidisciplinary, patient-centered care that adheres to established perioperative principles for non-obstetric surgery in pregnancy. The anesthesiologist plays a critical role in optimizing maternal and fetal outcomes within the pregnancy heart team.