{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T17:28:29Z","timestamp":1786728509598,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Valvular heart disease during pregnancy and labor poses a significant threat to maternal and fetal outcomes, increasing morbidity. The physiological changes of pregnancy in a parturient with stenotic and regurgitant lesions increases the risk of cardiac decompensation. Moderate-to-severe stenotic lesions can deteriorate in pregnancy due to an increase in workload on the heart, leading to complications such as congestive heart failure, atrial fibrillation, and thromboembolism. Maintaining uteroplacental perfusion and systemic vascular resistance in a fixed output state is quite challenging during the perioperative period. There is no single best technique for the management of such patients for labor or cesarean section. A good understanding of the normal physiological changes with their impact on the pathophysiology and the severity of the lesion will help in successful perioperative management. We describe the anesthetic management of parturients with known valvular heart disease posted for emergencies as well as elective lower segment cesarean section.<\/jats:p>","DOI":"10.4103\/aam.aam_124_24","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:11Z","timestamp":1741132811000},"page":"483-485","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Anesthetic Management of Cesarean Sections in Parturients with Valvular Heart Disease"],"prefix":"10.4103","volume":"24","author":[{"given":"Shilpa A.","family":"Naik","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavya M.","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie C. R.","family":"Misquith","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Mahanta","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. K.","family":"Ranjan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"R1-20260423","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1111\/j.1471-0528.2000.tb10395.x","article-title":"Mitral stenosis in pregnancy: A four-year experience at King Edward VIII Hospital, Durban, South Africa","volume":"107","author":"Desai","year":"2000","journal-title":"BJOG"},{"key":"R2-20260423","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1161\/CIRCULATIONAHA.118.033465","article-title":"Rheumatic heart disease in pregnancy: Global challenges and clear opportunities","volume":"137","author":"French","year":"2018","journal-title":"Circulation"},{"key":"R3-20260423","doi-asserted-by":"crossref","first-page":"454","DOI":"10.4103\/sja.SJA_277_17","article-title":"Anesthesia in pregnancy with heart disease","volume":"11","author":"Luthra","year":"2017","journal-title":"Saudi J Anaesth"},{"key":"R4-20260423","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/0029-7844(96)00069-5","article-title":"A longitudinal study of maternal hemodynamics during normal pregnancy","volume":"88","author":"van Oppen","year":"1996","journal-title":"Obstet Gynecol"},{"key":"R5-20260423","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jacc.2005.02.085","article-title":"Valvular heart disease and pregnancy part I: Native valves","volume":"46","author":"Elkayam","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"R6-20260423","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.ccl.2012.05.004","article-title":"Physiologic changes during normal pregnancy and delivery","volume":"30","author":"Ouzounian","year":"2012","journal-title":"Cardiol Clin"},{"key":"R7-20260423","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/0002-9378(89)90765-5","article-title":"Maternal hemodynamic effects of uterine contractions by M-mode and pulsed-Doppler echocardiography","volume":"161","author":"Lee","year":"1989","journal-title":"Am J Obstet Gynecol"},{"key":"R8-20260423","doi-asserted-by":"crossref","first-page":"1387.","DOI":"10.1056\/NEJM200310023491419","article-title":"Valvular heart disease in pregnancy","volume":"349","author":"Mulder","year":"2003","journal-title":"N Engl J Med"},{"key":"R9-20260423","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s00540-007-0504-3","article-title":"Anesthesia for pregnant women with valvular heart disease: The state-of-the-art","volume":"21","author":"Kuczkowski","year":"2007","journal-title":"J Anesth"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_124_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:28:01Z","timestamp":1786724881000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_124_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,4]]},"references-count":9,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/aam.aam_124_24","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,4]]},"assertion":[{"value":"2024-07-11","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}