How is congenital heart disease managed during pregnancy

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Pulmonary artery catheterization is rarely required for most patients with congenital heart disease. Intrathecal opioid injections are good choices for labor analgesia when patients will not tolerate decreased systemic vascular resistance and decreased venous return. Epidural anesthesia is contraindicated in few, if any cardiac lesions, provided that the induction of anesthesia is slow and hemodynamic changes are treated promptly. Single-injection spinals for cesarean delivery are contraindicated in many patients with congenital heart disease.

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