Effect of normothermic pulsatile perfusion of extracorporeal circulation during pregnancy on maternal and fetal prognosis

Zhang Li; Yao Ximeng; Li Huili; Yu Fumin; Luo Zhichao; Lin Zhonglin; Meng Qingqing; Xiao Dengke; Zhang Xiaohua; Zhou Chengbin

doi:10.13498/j.cnki.chin.j.ecc.2023.06.02

Abstract：Objective To investigate the effects of cardiopulmonary bypass(CPB)pulsatile perfusion(PP)and normother-mia on the prognosis of pregnant women and their fetuses undergoing CPB surgery during pregnancy.Methods This paper retro-spectively analyzed 33 cases of pregnant women who underwent cardiac surgery under with CPB in Guangdong Provincial Peo-ple's Hospital from January 01,2014 to December 31,2020.The perfusion methods were nonpulsatile perfusion(NP)group and PP group,and the lowest temperature was divided by 35℃,<35℃ was the hypothermia group,and≥35℃ was the normother-mia group.In order to evaluate the joint effects of temperature and perfusion mode on patients,NP with hypothermia was set as group A,NP with normothermia was set as group B,PP with hypothermia was set as group C,and PP with normothermia was set as group D.Results For the common effects of temperature and perfusion mode on patients,groups A,B,C,and D were not sta-tistically significant in terms of maternal outcome,and the main effects of perfusion mode were statistically significant(P<0.05)for maternal 24h postoperative hemoglobin,24h prothrombin time(PT),and 24h postoperative maximum lactate(Lac)values.The 24h postoperative hemoglobin levels of patients in the PP group were 9.83 g/L higher than those of patients in the NP group(95%CI:0.80-18.86);Postoperative 24h PT was 2.25 s less than that of the NP group(95%CI:0.45-4.05);and the level of the highest Lac value level at 24 h postoperatively was 1.96 mmol/L lower than that in NP group(95%CI:0.25-3.66).The main ef-fect of the lowest temperature had a statistically significant effect on the duration of maternal hospitalization(P<0.01),with pa-tients in the normothermia group spending 13.08 days less in hospital than those in the hypothermia group(95%CI:3.49-22.67).Fetal mortality on the 28th postoperative day in mothers was statistically significant among the four groups(P<0.05),and group D(mortality rate of 5.26%)was significantly better than the other three groups(P<0.05).Conclusion Normal temperature PP during CPB in pregnancy can reduce intraoperative blood destruction in mothers,improve maternal coagulation function and in-ternal environment,and reduce hospitalization time,as well as reducing fetal mortality.