Care of the pregnant patient with a pacemaker.

This article has reviewed cardiovascular adaptations to pregnancy and parturition. It has presented a basic overview of pacemaker supported cardiovascular function and related that to pregnancy. It has summarized 22 previously reported cases of pregnancy among women with pacemakers and reported yet another such case. The following conclusions can be drawn: The pregnant woman with a pacemaker, especially one that is not rate-responsive, faces risks for destabilized cardiovascular adaptation during the course of pregnancy, labor, and delivery. Individualized, ongoing nursing assessment focusing on detecting early signs of compromised cardiac output is critical in order to avoid maternal as well as fetal distress. Pregnancy has a high probability of coming to successful conclusion when professionals anticipate potential complications and monitor for early signs of difficulty. Providing care for the woman with a pacemaker presents many challenges to the perinatal nursing staff providing antepartum, intrapartum, and postpartum care. The woman, the fetus or newborn, and the family are best cared for by a multidisciplinary team whose members bring specialized knowledge and skill to bear on the needs she and the fetus present.