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Intrauterine pregnancy and aortic valve replacement
D A Paulus1, A J Layon, W R Mayfield
1Department of Anesthesiology, College of Medicine, University of Florida, Gainesville 32610-0254, USA.
Cardiopulmonary bypass (CPB) does not appear to cause excessive maternal risk, but the potential for fetal complications is of great concern. In general, operative intervention should be delayed until at least the second trimester. When this is not possible, ethical issues arise and a clash of maternal autonomy versus "fetal rights" ensues. This conflict is further complicated by maternal status changes that may accompany valvular disease or develop after CPB. The case described herein summarizes and discusses these conflicts.
Cardiopulmonary bypass (CPB) does not appear to cause excessive maternal risk, but the potential for fetal complications is of great concern. In general, operative intervention should be delayed until at least the second trimester. When this is not possible, ethical issues arise and a clash of maternal autonomy versus "fetal rights" ensues. This conflict is further complicated by maternal status changes that may accompany valvular disease or develop after CPB. The case described herein summarizes and discusses these conflicts.