Obstet Gynecol Clin North Am. 2026 Dec;53(4):781-801. doi: 10.1016/j.ogc.2026.06.004. Epub 2026 Aug 11.
ABSTRACT
Pregnant patients with cardiovascular disease benefit from early evaluation by a pregnancy heart team and formal risk stratification to guide delivery planning and determine the need for care at a tertiary center. Carefully titrated neuraxial anesthesia is preferred to reduce maternal catecholamines, decrease cardiac workload, and enable controlled hemodynamic management. From a cardiovascular standpoint, vaginal delivery is generally favored over cesarean delivery due to its more gradual hemodynamic changes and lower physiologic stress. Intrapartum management should be guided by lesion-specific physiology, with contingencies in place for obstetric and cardiac emergencies.
PMID:42951444 | DOI:10.1016/j.ogc.2026.06.004