Labor and delivery in the presence of mitral stenosis: Central hemodynamic observations
During a 1-year period, eight patients with New York Heart Association Class III or IV mitral stenosis were studied throughout the peripartum period with a pulmonary artery catheter. All patients were delivered vaginally. Intrapartum management was based upon cautious diuresis for preload optimizati...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 1985-08, Vol.152 (8), p.984-988 |
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| container_end_page | 988 |
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| container_issue | 8 |
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| container_title | American journal of obstetrics and gynecology |
| container_volume | 152 |
| creator | Clark, Steven L. Phelan, Jeffrey P. Greenspoon, Jeffrey Aldahl, Denise Horenstein, Janet |
| description | During a 1-year period, eight patients with New York Heart Association Class III or IV mitral stenosis were studied throughout the peripartum period with a pulmonary artery catheter. All patients were delivered vaginally. Intrapartum management was based upon cautious diuresis for preload optimization and heart rate control with propranolol. A mean increase in pulmonary capillary wedge pressure of 10 mm Hg was observed in the immediate postpartum period. Only two patients demonstrated a significant increase in cardiac output during this same time period. Central venous pressure correlated poorly with pulmonary capillary wedge pressure in seven of eight patients. Neonatal outcome was uniformly excellent. With the management approach described, no patient exhibited deterioration of cardiopulmonary status during the peripartum period. |
| doi_str_mv | 10.1016/0002-9378(85)90544-7 |
| format | Article |
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All patients were delivered vaginally. Intrapartum management was based upon cautious diuresis for preload optimization and heart rate control with propranolol. A mean increase in pulmonary capillary wedge pressure of 10 mm Hg was observed in the immediate postpartum period. Only two patients demonstrated a significant increase in cardiac output during this same time period. Central venous pressure correlated poorly with pulmonary capillary wedge pressure in seven of eight patients. Neonatal outcome was uniformly excellent. 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Obstetrics ; Heart Rate ; Hemodynamics ; Humans ; Labor, Obstetric ; Maternal, fetal and perinatal monitoring ; Medical sciences ; Mitral stenosis ; Mitral Valve Stenosis - physiopathology ; Parity ; Postpartum Period ; Pregnancy ; Pregnancy Complications, Cardiovascular - physiopathology ; pulmonary artery catheter ; Pulmonary Wedge Pressure ; Stroke Volume</subject><ispartof>American journal of obstetrics and gynecology, 1985-08, Vol.152 (8), p.984-988</ispartof><rights>1985</rights><rights>1986 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c386t-903d44cd6ba0185b6babcb67b115e6e3b5f6a874caf16b2cf3695c78624f2f4b3</citedby><cites>FETCH-LOGICAL-c386t-903d44cd6ba0185b6babcb67b115e6e3b5f6a874caf16b2cf3695c78624f2f4b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0002-9378(85)90544-7$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8621689$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/4025461$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clark, Steven L.</creatorcontrib><creatorcontrib>Phelan, Jeffrey P.</creatorcontrib><creatorcontrib>Greenspoon, Jeffrey</creatorcontrib><creatorcontrib>Aldahl, Denise</creatorcontrib><creatorcontrib>Horenstein, Janet</creatorcontrib><title>Labor and delivery in the presence of mitral stenosis: Central hemodynamic observations</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>During a 1-year period, eight patients with New York Heart Association Class III or IV mitral stenosis were studied throughout the peripartum period with a pulmonary artery catheter. All patients were delivered vaginally. Intrapartum management was based upon cautious diuresis for preload optimization and heart rate control with propranolol. A mean increase in pulmonary capillary wedge pressure of 10 mm Hg was observed in the immediate postpartum period. Only two patients demonstrated a significant increase in cardiac output during this same time period. Central venous pressure correlated poorly with pulmonary capillary wedge pressure in seven of eight patients. Neonatal outcome was uniformly excellent. With the management approach described, no patient exhibited deterioration of cardiopulmonary status during the peripartum period.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization</subject><subject>cardiac disease</subject><subject>Cardiac Output</subject><subject>Delivery, Obstetric</subject><subject>Delivery. Postpartum. Lactation</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Heart Rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Labor, Obstetric</subject><subject>Maternal, fetal and perinatal monitoring</subject><subject>Medical sciences</subject><subject>Mitral stenosis</subject><subject>Mitral Valve Stenosis - physiopathology</subject><subject>Parity</subject><subject>Postpartum Period</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Cardiovascular - physiopathology</subject><subject>pulmonary artery catheter</subject><subject>Pulmonary Wedge Pressure</subject><subject>Stroke Volume</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1985</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1rGzEQhkVoSd0k_6AFHUppD5tIWn1tDoVi2qRgyKWlRyFpR0RlV3KltcH_vrux8bGnYWaeGV4ehN5RcksJlXeEENZ0rdKftPjcEcF5oy7QipJONVJL_Qqtzsgb9LbWP0vLOnaJLjlhgku6Qr831uWCbepxD0PcQzngmPD0DHhboELygHPAY5yKHXCdIOUa6z1eQ3qZPMOY-0OyY_Q4uwplb6eYU71Gr4MdKtyc6hX69f3bz_Vjs3l6-LH-uml8q-XUdKTtOfe9dJZQLdxcnXdSOUoFSGidCNJqxb0NVDrmQys74ZWWjAcWuGuv0Mfj323Jf3dQJzPG6mEYbIK8q0ZJJihT7QzyI-hLrrVAMNsSR1sOhhKz-DSLHbPIMlqYF59GzWfvT_93boT-fHQSOO8_nPa2ejuEYpOP9YzNQanU3Yx9OWIwu9hHKKb6uMjtYwE_mT7H_-f4B7Ofkho</recordid><startdate>19850815</startdate><enddate>19850815</enddate><creator>Clark, Steven L.</creator><creator>Phelan, Jeffrey P.</creator><creator>Greenspoon, Jeffrey</creator><creator>Aldahl, Denise</creator><creator>Horenstein, Janet</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19850815</creationdate><title>Labor and delivery in the presence of mitral stenosis: Central hemodynamic observations</title><author>Clark, Steven L. ; Phelan, Jeffrey P. ; Greenspoon, Jeffrey ; Aldahl, Denise ; Horenstein, Janet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-903d44cd6ba0185b6babcb67b115e6e3b5f6a874caf16b2cf3695c78624f2f4b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1985</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cardiac Catheterization</topic><topic>cardiac disease</topic><topic>Cardiac Output</topic><topic>Delivery, Obstetric</topic><topic>Delivery. Postpartum. Lactation</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Heart Rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Labor, Obstetric</topic><topic>Maternal, fetal and perinatal monitoring</topic><topic>Medical sciences</topic><topic>Mitral stenosis</topic><topic>Mitral Valve Stenosis - physiopathology</topic><topic>Parity</topic><topic>Postpartum Period</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Cardiovascular - physiopathology</topic><topic>pulmonary artery catheter</topic><topic>Pulmonary Wedge Pressure</topic><topic>Stroke Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clark, Steven L.</creatorcontrib><creatorcontrib>Phelan, Jeffrey P.</creatorcontrib><creatorcontrib>Greenspoon, Jeffrey</creatorcontrib><creatorcontrib>Aldahl, Denise</creatorcontrib><creatorcontrib>Horenstein, Janet</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clark, Steven L.</au><au>Phelan, Jeffrey P.</au><au>Greenspoon, Jeffrey</au><au>Aldahl, Denise</au><au>Horenstein, Janet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Labor and delivery in the presence of mitral stenosis: Central hemodynamic observations</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>1985-08-15</date><risdate>1985</risdate><volume>152</volume><issue>8</issue><spage>984</spage><epage>988</epage><pages>984-988</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>During a 1-year period, eight patients with New York Heart Association Class III or IV mitral stenosis were studied throughout the peripartum period with a pulmonary artery catheter. All patients were delivered vaginally. Intrapartum management was based upon cautious diuresis for preload optimization and heart rate control with propranolol. A mean increase in pulmonary capillary wedge pressure of 10 mm Hg was observed in the immediate postpartum period. Only two patients demonstrated a significant increase in cardiac output during this same time period. Central venous pressure correlated poorly with pulmonary capillary wedge pressure in seven of eight patients. Neonatal outcome was uniformly excellent. With the management approach described, no patient exhibited deterioration of cardiopulmonary status during the peripartum period.</abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>4025461</pmid><doi>10.1016/0002-9378(85)90544-7</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9378 |
| ispartof | American journal of obstetrics and gynecology, 1985-08, Vol.152 (8), p.984-988 |
| issn | 0002-9378 1097-6868 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Adult Biological and medical sciences Cardiac Catheterization cardiac disease Cardiac Output Delivery, Obstetric Delivery. Postpartum. Lactation Female Gestational Age Gynecology. Andrology. Obstetrics Heart Rate Hemodynamics Humans Labor, Obstetric Maternal, fetal and perinatal monitoring Medical sciences Mitral stenosis Mitral Valve Stenosis - physiopathology Parity Postpartum Period Pregnancy Pregnancy Complications, Cardiovascular - physiopathology pulmonary artery catheter Pulmonary Wedge Pressure Stroke Volume |
| title | Labor and delivery in the presence of mitral stenosis: Central hemodynamic observations |
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