• Perioperative prevention of obstetric and perinatal complications in pregnants undergoing extracorporeal circulation interventions
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Perioperative prevention of obstetric and perinatal complications in pregnants undergoing extracorporeal circulation interventions

PERINATOLOGIYA I PEDIATRIYA. 2017.2(70):32-36; doi 10.15574/PP.2017.70.32

Lazorishynets V. V., Davydova Iu. V., Krykunov A. A., Ogorodnyk A. O., Kravchenko V. I.
SI «Amosov National Institute of Сardiovascular Surgery of NAMS of Ukraine», Kyiv, Ukraine
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv, Ukraine

In total 10 cardiovascular surgeries with extracorporeal circulation in pregnants with severe cardiovascular pathology have been performed. It was shown that the perioperative prophylaxis of miscarriage and preterm premature births in these female patients by vaginal administration of micronized progesterone (Utrogestan) allows reaching the term of planned caesarean section (39 weeks of gestation) and the birth of healthy children. The choice of the agent is due to the high safety level, efficacy, and the possibility of administration during all trimesters of pregnancy, which is crucial in the prevention of not only obstetric and perinatal complications, but also severe cardiological ones after the open-heart operations across pregnancy.

Key words: severe cardiovascular pathology, pregnancy, cardiovascular surgeries with extracorporeal circulation, prevention of obstetric and perinatal complications, Utrogestan.

1. Sepehripour А, Lo T, Shipolini A, McCormackc D. (2012). Can pregnant women be safely placed on cardiopulmonary bypass? Interact Cardiovasc Thorac Surg. 15(6): 1063—1070. https://doi.org/10.1093/icvts/ivs037; https://doi.org/10.1093/icvts/ivr094; https://doi.org/10.1093/icvts/ivs177; https://doi.org/10.1093/icvts/ivr016; https://doi.org/10.1093/icvts/ivs011; https://doi.org/10.1093/icvts/ivs318; PMid:22945848 PMCid:PMC3501292

2. Patel A, Asopa S, Tang AT et al. (2008). Cardiac surgery during pregnanc. Tex Heart Inst J. 35(3): 307—312. PMid:18941609 PMCid:PMC2565548

3. John AS, Gurley F, Sсhaff HV et al. (2011). Cardiopulmonary bypass during pregnancy. Ann Thorac Sur. 91(4): 1191—1196.

4. Dubourg G, Broustet P, Bricaud H et al. (1959). Complete correction of a triad of Fallot, in extracorporeal circulation, in a pregnant woman. Arch Mal Coeur Vaiss. 52: 1389—1391. PMid:13818349

5. Hosseini S, Kashfi F, Samiei N et al. (2015). Feto-maternal outcomes of urgent open-heart surgery during pregnancy. J Heart Valve Dis. 24(2): 253—9. PMid:26204695

6. Mahli A, Izdes S, Coskun D. (2000). Cardiac operations during pregnancy: review of factors influencing fetal outcom. Ann Thorac Surg. 69: 1622—1626. https://doi.org/10.1016/S0003-4975(00)01178-4

7. John AS, Connolly HM, Schaff HV, Klarich K. (2012). Management of cardiac myxoma during pregnancy: a case series and review of the literature. Int J Cardiol. 155: 177—80. https://doi.org/10.1016/j.ijcard.2011.05.069; PMid:21715030

8. Yang P, Zhang J, Li Y et al. (2015). Maternal and fetal outcomes with aortic dissection in pregnant patients with Marfan syndrome. Zhonghua Fu Chan Ke Za Zhi. 50(5): 33—40.

9. Stangl V, Schad J, Gossing G et al. (2008). Maternal heart disease and pregnancy outcome: a single-centre experience. Eur J Heart Fail. 10: 855—860. https://doi.org/10.1016/j.ejheart.2008.07.017; PMid:18760667

10. Muretti M, Torre TM, Mauri R et al. (2010). Mitral valve replacement in pregnancy: a successful strategy for fetal survival. J Heart Valve Dis. 19: 789—791. PMid:21214106

11. Yates MT, Soppa G, Smelt J et al. (2015). Perioperative management and outcomes of aortic surgery during pregnancy. The Journal of Thoracic and Cardiovascular Surgery. 149; Is 2: 607-610.

12. Pieper PG, Hoendermis ES, Drijver YN. (2012). Cardiac surgery and percutaneous intervention in pregnant women with heart disease. Neth Heart J. 20: 125—128. https://doi.org/10.1007/s12471-011-0209-y; https://doi.org/10.1007/s12471-012-0244-3; PMid:22351585 PMCid:PMC3286507

13. Jafferani A, Malik A, Khawaja RD et al. (2011). Surgical management of valvular heart diseases in pregnancy. Eur J Obstet Gynecol Reprod Biol. 15: 91—4. https://doi.org/10.1016/j.ejogrb.2011.07.032; PMid:21839576

14. Yuan S-M. (2014). Indications for Cardiopulmonary Bypass During Pregnancy and Impact on Fetal Outcomes. Geburtshilfe Frauenheilkd. 74(1): 55—62. https://doi.org/10.1055/s-0033-1350997; PMid:24741119 PMCid:PMC3964359

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