Modifying labor routines for the woman with cardiac disease

The childbearing woman with cardiac disease presents a unique challenge to healthcare providers. The physiologic adaptations that accompany pregnancy and labor predispose the woman with cardiac disease to cardiac decompensation. Ideally, these women are identified to perinatal nursing staff prior to admission to the hospital in labor or for obstetrical procedures in order to provide adequate time for review of the specific cardiac lesion and development of an interdisciplinary plan of care. This article provides a comprehensive review of typical intrapartum routines that require modification and discusses strategies for adapting labor management for the woman with cardiac disease.