title: Use of Doppler ultrasound in the management of uteroplacental perfusion during cardiopulmonary bypass in pregnancy.
abstract: Cardiopulmonary bypass, the extreme of non-obstetric surgery during pregnancy, presents unique challenges to minimize maternal and fetal risk. We present our experience with a woman who was diagnosed with a left atrial myxoma following an ischemic cerebrovascular accident. We discuss clinical management specific to cardiopulmonary bypass during pregnancy and delivery in the context of a multidisciplinary team approach. We recommend using intermittent Doppler ultrasound as a non-invasive real-time assessment of uteroplacental perfusion during non-obstetric surgery in pregnancy. Monitoring of perfusion facilitates active feedback for appropriate in utero resuscitation in these cases.
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Department of OB/GYN, Division of Maternal Fetal Medicine, Madison, WI, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Mandel
authors.affiliation: Madison Anesthesiology Consultants, LLP, Madison, WI, USA.
authors.forename: P G
authors.initials: PG
authors.lastname: Pryde
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Department of OB/GYN, Division of Maternal Fetal Medicine, Madison, WI, USA.
authors.forename: D M
authors.initials: DM
authors.lastname: Shah
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Department of OB/GYN, Division of Maternal Fetal Medicine, Madison, WI, USA. Electronic address: iruretagoyen@wisc.edu.
authors.forename: J I
authors.initials: JI
authors.lastname: Iruretagoyena
mesh_terms: D000328:Adult; D002315:Cardiopulmonary Bypass; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D006801:Humans; D021041:Placental Circulation; D011247:Pregnancy; D018608:Ultrasonography, Doppler / Q000379:methods*
keywords: Cardiac myxoma; Cardiopulmonary bypass; Fetal Doppler; Pregnancy