Cardiac operations during pregnancy: Review of factors influencing fetal outcome

Women with underlying rheumatic heart disease, even if well compensated, ca n easily be affected by acute heart failure caused by out-of-the-ordinary c ardiorespiratory requirements during pregnancy. In such cases, medical ther apy is not always sufficient to drive a heart, and open heart operation mig ht be necessary. Many factors associated with cardiac operations requiring cardiopulmonary bypass, such as hypothermia, can adversely affect both the mother and the fetus, but the morbidity and mortality rates are higher for the fetus than the mother. Because fetal heart tones were lost during cardi opulmonary bypass and were reheard in the intensive care unit in our case p resentation, we have presumed that the loss of fetal heart tones should not always indicate fetal death and have discussed harmful factors in relation with the fetal morbidity and mortality in light of the literature. (C) 200 0 by The Society of Thoracic Surgeons.