Abstract

MONSALVE, Germán A et al. Pregnant patient with cardiac diseases Risk based peripartum management: Case series 2005-2009. Rev. colomb. anestesiol. [online]. 2010, vol.38, n.3, pp.348-360. ISSN 0120-3347.

Objetive. We report a series of obstetric patients with a wide range of cardiac diseases, using a risk based strategy to develop peripartum plans in which the anesthetic management is included. Methodos. Case reports. Retrospective analysis of 37pregnant patients with a wide range of cardiac diseases admitted to the High Dependency Unit of Clínica del Prado, in Medellín, Colombia from 2005 to 2009. Results. From a total of 37 patients, 15 had congenital heart disease, 13 valvular disease, 5 postpartum cardiomyopathy, and the other 4 included rhythm abnormalities and ischemic heart disease. CARPREG study criteria were used for risk stratification. Eight patients were identified in the high risk group, and the rest as intermediate and low risk. Most of the patients had regional anesthesia management (89.2 %). The decision for caesarean section was decided for obstetric indication was performed in 35 % of the cases. There were cardiac complications in 10.8 % of the cases and there were no maternal deaths. Conclusions. The application of a morbidity and mortality cardiac risk stratification protocol in pregnant women allows the anesthesiologist to participate in a multispecialty treatment team, and so they are able to achieve the best possible maternal outcome in this group of patients.

Keywords : Heart diseases; pregnancy complications; risk; anesthesia.

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