➤ Avoid CPB if possible
➤ If possible perform in 2nd trimester
➤ Continuous FHR monitoring
➤ Avoid acidosis & low PaO2
➤ Keep flow rates > 3 lit/min/m2
➤ Maintain perfusion pressure above 65 mmhgbfor adequate flow to fetus
➤ Low HCT > 22%
➤ Turn patient to left 15-20*C to keep gravid uterus off the IVC
➤ ACT maintaining
➤ Do not cool
➤ Restrict cardioplegia to minimum & aspirate away
➤ Avoid alpha agonist
➤ Advice tocolytics

LWMH-crosses placenta so avoid

How much blood to be added
(BV+PV)*desired HCT-BV*HCT of patient/HCT of donor blood

Flow calculation of pump
➤ BSA*2.5 L/min
➤ <7 kg-120-200 ml//hr/kg
➤ 7-10 kg-100-1500 ml/kg
➤ 10-20 kg-80-120 ml/kg
➤ >20 kg-2.4L/min/kg

Speed of cooling & rewarming
➤ 1-1.5*c/min
➤ 0.3-0.5*c/min

Sources of free radicals
➤ lipid peroxidation
➤ neutrophil mitochondria
➤ conversion of hypoxanthine to xanthane
➤ arachnoid acid metabolite
➤ heber wiss reaction