Pericardiectomy in pregnancy

Abstract

Details are presented which relate to a patient in whom constrictive pericarditis developed during pregnancy. Successful pericardiectomy was performed at 24 weeks' gestation and a normal infant was delivered at term. The results of medical and surgical treatment of cardiac patients during pregnancy, the results of pericardiectomy, and the risk to the foetus are discussed. (Ueland, 1965), and correction of these lesions has therefore been the type of operation most commonly undertaken.Constrictive pericarditis is a common lesion in those parts of the world where tuberculosis is uncontrolled. Many patients with tuberculosis are infertile, so that the occurrence of pregnancy in patients with constrictive pericarditis is relatively rare. The purpose of this paper is to report the details which relate to a patient in whom pericardiectomy was undertaken in pregnancy.third heart sound. The liver was palpable 9 cm. below the right costal margin, and the spleen 1 cm. below the left. The fundus of the uterus was felt 3 cm. below the umbilicus, consistent with the twenty-fourth week of pregnancy. Foetal heart sounds were normal.Laboratory investigations showed a haemoglobin of 10 5 g. / 100 ml.; a white cell count of 6,000 per cu. mm.; an erythrocyte sedimentation rate of 51 mm.in the first hour; and a blood urea of 18 mg./O00 ml.A tuberculin test was positive.The electrocardiogram (Fig. 1) showed sinus tachycardia, at a rate of 125 per minute, and a mean frontal QRS axis of +10°. low voltage in the standard leads and generalized ST-T wave depression or inversion. The chest radiograph (Fig. 2) showed bilateral pleural effusions, a heart shadow with a -J~~AA.m-

Pericardial Disease in Pregnancy

“…This finding most likely indicates fetal distress due to a decrease in placental blood flow and can frequently be managed by increasing the flow rate [37]. Previous pericardiectomy is not regarded as a risk for subsequent pregnancies [38,39].…”

Pregnancy complicating irradiation‐induced constrictive pericarditis

“…Although in most patients, management can be conservative, assessment of the hemodynamic significance of pericardial constriction is mandatory for planning treatment. Surgical resection of the pericardium is indicated in patients who manifest hemodynamic compromise which may prevent adequate placental blood flow, since restriction of left ventricular filling can prevent the physiologic increase in cardiac output during pregnancy and jeopardize normal fetal growth and development (2,3,4). Removal of the pericardium has been performed during pregnancy with good outcome (2,3,6).…”

“…Constrictive pericarditis in pregnancy is very rare (1,2,3). Although it is believed that women with the disease, who are in a satisfactory clinical state before pregnancy, may be expected to cope with pregnancy and labor without problems (I), this report illustrates that irradiation-induced constrictive pericarditis may complicate pregnancy, regardless of the clinical state prior to conception.…”

Pregnancy and Pericardial Diseases

“…Bu bulgu çoğunlukla muhtemelen plasental kan akımının azalmasında ötü-rü oluşan fetal distresi gösterir ve sıklıkla artan plasental kan akımı oranı ile yönetilir. Geçirilmiş perikardioektomi öyküsü ileriki gebelikler yönünden herhangi bir risk içermemektedir 5,6,29,30 . Gebe kadınlarda perikardın etkilendiği klinik hadiselere yaklaşım temel olarak gebe olmayan bireylerden farklılık göstermese de gebeliğe özgü tedavi ve tedbir uygulamalarının yapılması gereklidir.…”