Cardio-Obstetric Anesthesia at SOAP: Hemodynamics, Monitoring, and Preeclampsia

At the SOAP meeting in Montreal, Desiree Chappell and Monty Mythen interview Dr. Marie Louise Meng, Assistant Professor of Anesthesiology at Duke University Department of Anesthesiology and her former cardio-obstetric fellow Liliane Ernst, assistant professor in the Obstetric and Gynecologic Anesthesia section Wake Forest University. The conversation focuses on cardio-obstetric anesthesia, hemodynamics, monitoring, and patient-centered care. Meng describes building multidisciplinary "pregnancy heart teams" to plan management for complex cardiac disease in pregnancy and reduce birth trauma. Ernst discusses research using the Premier database on preexisting atrial fibrillation in pregnancy (about 25 per 100,000 deliveries) and associated management and outcomes. They review cases including mechanical circulatory support with an Impella to prolong pregnancy and highlight knowledge gaps about placental perfusion and pulsatility, including Fontan physiology. Meng outlines individualized hemodynamic monitoring for labor and C-sections, emphasizes recognizing hypertensive instability, and details preeclampsia with severe features, its end-organ criteria, incidence, disparities, postpartum follow-up challenges, and potential use of remote monitoring and noninvasive cardiac output/SVR monitoring to guide therapy. Monty Mythen, founding editor-in-chief of TopMedTalk, is now Senior Vice President, Scientific Liaison, BD Advanced Patient Monitoring. He is also Emeritus Professor of Anaesthesia and Critical Care, University College London, UK. Desirée Chappell, former co-editor-in-chief of TopMedTalk, is now Director of Medical Affairs and Medical Science Liaison, BD Advanced Patient Monitoring. She is also a CRNA at NorthStar Anesthesia, USA. -- Join us at Evidence Based Perioperative Medicine (EBPOM) World Congress 2026 in London. Be part of a global conversation as clinicians from around the world gather between 7-9th July at the British Library in London. Three days of evidence-based perioperative medicine, global insights, and expert debate—featuring speakers including Michael Marmot and Ken Rockwood. Register here - EBPOM World Congress 2026