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Anesthetic Management of the Newly Diagnosed or Decompensating Cardio-Obstetric Patient

Liliane Ernst1, Hanna Hussey2, Johanna Quist-Nelson3

  • 1Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Anesthesiology Clinics
|July 30, 2026
PubMed

Insights

Cardiovascular disease (CVD) in pregnancy poses significant risks. Multidisciplinary pregnancy heart teams (PHTs) are crucial for managing these high-risk patients, requiring tailored delivery plans.

Area of Science:

  • Cardiology
  • Obstetrics
  • Anesthesiology

Background:

  • Cardiovascular disease (CVD) is a primary cause of maternal mortality.
  • Patients with new or worsening CVD during pregnancy face high risks of morbidity and mortality.
  • Pregnancy heart teams (PHTs) offer multidisciplinary care for cardio-obstetric patients.

Purpose of the Study:

  • To highlight the importance of PHTs in managing cardio-obstetric patients.
  • To emphasize the need for individualized delivery plans considering hemodynamic changes during pregnancy and postpartum.

Main Methods:

  • Multidisciplinary team approach involving cardio-obstetric specialists.
  • Assessment of cardiovascular lesion pathophysiology.
  • Consideration of hemodynamic alterations throughout pregnancy, labor, delivery, and postpartum.

Main Results:

  • PHTs facilitate comprehensive management of cardio-obstetric patients.
  • Delivery plans must integrate patient-specific cardiac conditions with physiological changes of pregnancy.
  • Anesthesiologists play a vital role within the PHT.

Conclusions:

  • Multidisciplinary management via PHTs is essential for high-risk pregnancies with CVD.
  • Evidence-based guidelines are needed to optimize the care of cardio-obstetric patients.
  • Further research is required to inform best practices in managing CVD during pregnancy.

Keywords:
Cardio-obstetricsCardiovascular diseaseHeart diseaseMechanical circulatory supportPregnancyPregnancy heart team

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