Shunt flow and pulmonary hemodynamics during labor and delivery in the Eisenmenger syndrome

Jay Midwall, Hherbert Jaffin, Michael V. Herman, Joel Kupersmith

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

The Eisenmenger syndrome carries a high mortality rate in women during delivery and the Immediate postpartum period. It has been suggested that marked changes in shunt flow and pulmonary hemodynamics may be responsible. These functions were studied under various physiologic and pharmacologic conditions during labor and delivery in a patient with the Eisenmenger syndrome. Uterine contractions were associated with a decrease in the ratio of pulmonary to systemic blood flow (Qp/Qs) from 1.58 to 1.05. The Qp/Qs ratio also decreased (to 0.83) when forceps were applied during uterine contractions. Epidural anesthesia, oxytocln and the supine position did not adversely affect pulmonary hemodynamics or shunt flow. On the basis of these results, if pregnancy cannot be terminated in a patient with the Eisenmenger syndrome, It is recommended that the patient be given high concentrations of oxygen and epldural anesthesia and that serial arterial blood gas determinations be performed to detect changes in shunt flow.

Original languageEnglish
Pages (from-to)299-303
Number of pages5
JournalAmerican Journal of Cardiology
Volume42
Issue number2
DOIs
StatePublished - Aug 1978
Externally publishedYes

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