Regional anesthesia for the pregnant cardiac patient

الملخص AR

The pregnant patient with heart disease presents an extreme challenge to both the obstetrician and anesthetist.

Pregnancy and labor each impose increased demands on the circulation, and anesthesia for delivery, either vaginally or surgically, may compromise an already stressed cardiovascular system.

To avoid creating such problems or aggravating existing conditions, the anesthetist must be aware of the nature and progression of heart disease during pregnancy, the normal physiology of labor, delivery and puerperium, the cardiovascular effects of the various anesthesia regimens, and the therapies used to manage untoward complications should they occur.

Both anesthetic and obstetric considerations will be discussed.

Regional anesthesia for specific cardiac lesions/conditions will also be considered, with the emphasis on indications and contraindications.