| Autor: |
Joe Khalifeh, Assaad Maalouf, Elie Anastasiades, Nadine Kawkabani, Rawad Halimeh, Moussa Abi Ghanem, Simon Bejjani, Omar Boustros, Roula Darwish, Bassam Abou Khalil |
| Rok vydání: |
2019 |
| Předmět: |
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| Zdroj: |
International Journal of Cardiovascular and Thoracic Surgery. 5:21 |
| ISSN: |
2575-4866 |
| Popis: |
Two percent of pregnant women experience some type of cardiac pathologic disease. In some cases surgery becomes mandatory to save the mother’s life. The maternal mortality rate in pregnant women undergoing open heart procedures is around 2.9% while the fetal mortality rate ranges between 9.5 to 29%. Many papers have advanced measures in order to decrease fetal morbidity and mortality such as tepid to normothermic cardiopulmonary bypass, good oxygenation, high hematocrit, pulsatile flow, alpha stat management, mean arterial pressure around 70mmhg and a pump flow above 2.4l/min. They recommend also a close monitoring of the fetal heart rate, uteroplacental blood flow and uterine contractions We report in this paper, the case of a 26 year old pregnant female who underwent at 18 weeks an aortic valve replacement. Severe fetal bradycardia occurred 30 min after going on bypass lasted for 20 min and was refractory to a further increase in pump flow, mean arterial pressure and hematocrit. The fetal heart rate returned to its baseline only after rewarming the patient to 35.5 degrees Celsius. The post-operative course was uneventful and a close follow up revealed a normal fetal status. At 38 weeks the mother delivered a healthy normal baby girl. Since fetal bradycardia occurred despite respecting all the recommendations and only reversed after rewarming the mother to 35.5 degrees Celsius, we would suggest not lowering the temperature during cardiopulmonary bypass below 35.5 degrees in pregnant patients undergoing cardiac procedures. Thus more reports and papers are mandatory in order to further elucidate the factors responsible of the adverse events that occur in such cases. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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