Anesthetic and Analgesic Considerations in Pregnant Patients With Cardiac Disease

Successful anesthetic management of pregnant patients with cardiac disease requires an understanding of both maternal physiology and alterations induced by labor analgesia and anesthesia for cesarean delivery. This review provides an overview of physiological changes of pregnancy pertinent to obstetric anesthesiology in regard to patients with cardiac disease, including modifications to labor analgesic techniques, indications for additional monitoring, and both regional anesthetic and general anesthetic management of complex cardiac patients for cesarean delivery. The importance of a comprehensive pregnancy heart team cannot be overstated, especially when managing patients with very high-risk cardiac comorbidities.