John G. Gianopoulos

Establishing the Criteria for Anesthesia and Other Precautions for Surgery During Pregnancy

Surgical procedures may be undertaken in the gravida with relatively little risk to the fetus or the continuation of pregnancy. The managing physician requires a thorough knowledge of the maternal physiologic adaptations to pregnancy to minimize maternal iatrogenic risks. The potential fetal effects of the planned procedure, diagnostic tests, therapeutic drugs, and anesthesia must be considered preoperative. Any potential fetal risks must be discussed with the patient and, in some cases, maternal need may obviate undertaking some procedures that place the fetus at some jeopardy. The outcome in most situations of surgery on the gravida is good for both the mother and the fetus.

Cardiac disease in pregnancy.

Pregnancy produces many hemodynamic alterations of the cardiovascular system. Consideration of these alterations must be given in the management of pregnant patients with cardiac disease. This article reviews the cardiovascular hemodynamic alterations of pregnancy, and the management of pregnant patients with specific cardiac lesions.