Use of Doppler ultrasound in the management of uteroplacental perfusion during cardiopulmonary bypass in pregnancy

•During cardiac surgery the fetus requires continuous assessment.•In our case fetal Doppler ultrasound was used during cardiopulmonary bypass.•Fetal monitoring resulted in changes to anesthetic management minimizing fetal risk.•Multidisciplinary planning and communication led to a successful outcome.

Cardiopulmonary bypass, the extreme of non-obstetric surgery during pregnancy, presents unique challenges to minimize maternal and fetal risk. We present our experience with a woman who was diagnosed with a left atrial myxoma following an ischemic cerebrovascular accident. We discuss clinical management specific to cardiopulmonary bypass during pregnancy and delivery in the context of a multidisciplinary team approach. We recommend using intermittent Doppler ultrasound as a non-invasive real-time assessment of uteroplacental perfusion during non-obstetric surgery in pregnancy. Monitoring of perfusion facilitates active feedback for appropriate in utero resuscitation in these cases.