Cv Diseases In Pregnancy

CV diseases in pregnancy • Lt → Rt shunt e.g. ASD, VSD, PDA are well tolerated in pregnancy • The main keys in management for anesthesia are o Avoid air bubble in the IV o For epidural insertion use saline instead of air both due to risk of paradoxical air embolism o Pain → ↑ catecholamine → ↑ SVR → shunt → RV failure o So early epidural is desirable o Slowly titrate the epidural, and avoid spinal → sudden ↓SVR → convert the shunt to Rt→ Lt o Give O2 all the time