American Journal of Obstetrics and Gynecology
Outcome of cardiovascular surgery and pregnancy: A systematic review of the period 1984-1996☆,☆☆
Section snippets
Search and analysis of the material
The original publications, describing a cardiovascular surgical procedure during pregnancy or after delivery, were identified in the database of the National Library of Medicine (MEDLINE) from January 1984 to December 1996. For the search the Key words pregnancy and cardiovascular surgery, cardiopulmonary bypass, anesthesia, cardiac disease, vascular disease, congenital heart disease, valvular heart disease, endocarditis, valve replacement, aortic dissection, aneurysm, Marfan’s syndrome,
Cardiovascular surgical cases and pregnancy, 1984-1996
A total of 161 cases (137 with and 24 without cardiopulmonary bypass) of various cardiovascular operations qualified for the review. Tables I and II show the duration of pregnancy on admission, at surgery, and at delivery and the maternal and fetal-neonatal outcome, respectively, according to the timing of surgery, whether performed during pregnancy or at delivery or delayed to the postpartum period. Table III presents the fetal-neonatal outcome of cardiopulmonary bypass procedures during
Limitations of the systematic review
Despite intensive search for published references, some reports certainly remained hidden because of the nonuniform Key words and the large numbers of sources. It is likely that more patients were operated on than reported in the study period. A good outcome obtained by an experienced team may be considered a routine success, not worthy of publication. Otherwise, a bias to report may depend on the outcome and result in a preferential number of successful procedures and an underreporting of
Acknowledgements
Robert A. Strickland, MD (Department of Anesthesiology, Mayo Clinic, Rochester, Minn), provided a detailed description of cases treated from 1985 to 1989 (see reference 7). Ms Machiko Hafner-Nakai (Zurich, Switzerland) translated the Japanese publications. Renate Huch, MD (Department of Perinatal Physiology and Obstetrics, University Hospital, Zurich, Switzerland), reviewed the manuscript and made valuable comments.
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Reprint requests: Branko M. Weiss, MD, Department of Anesthesiology, University Hospital, Rämistrasse 100, CH-8091 Zurich, Switzerland.
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