Cardiopulmonary bypass in pregnancy

Cardiopulmonary bypass (CPB) is infrequently utilized in pregnant patients and reserved for those with acute presentations requiring surgical intervention. Given the associated elevated risk to the mother and fetus, pertinent considerations are essential for the conduct of CPB. Timing of cardiac surgery with CPB, gestational age, and severity of cardiovascular disease play important roles in maternal and fetal outcomes. CPB after fetal delivery in those at advanced gestational age or premature delivery with cesarean section in those at early gestational age minimizes maternal and fetal risk. Greater detail on general considerations for CPB and those specific to common cardiac diseases in pregnancy is described in this chapter.