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Marie-Louise Meng

Assistant Professor of Anesthesiology
Anesthesiology, Women's

Selected Publications


Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Pulmonary Hypertension.

Journal Article Anesth Analg · May 1, 2024 BACKGROUND: Patients with pulmonary hypertension have a high risk of maternal morbidity and mortality. It is unknown if a trial of labor carries a lower risk of morbidity in these patients compared to a planned cesarean delivery. The objective of this stud ... Full text Link to item Cite

Hospital Discharge Codes and Overestimating Severe Maternal Morbidity During Delivery Hospitalization.

Journal Article Obstetrics and gynecology · April 2024 Our objective was to identify birth hospitalization severe maternal morbidity (SMM) diagnoses that were also coded during prior encounters and, thus, potentially falsely carried forward as de novo SMM events. This retrospective cohort study included pregna ... Full text Cite

Recommendations for the Management of High-Risk Cardiac Delivery: ACC Cardiovascular Disease in Women Committee Panel

Journal Article JACC: Advances · April 1, 2024 Maternal mortality is a major public health crisis in the United States. Cardiovascular disease (CVD) is a leading cause of maternal mortality and morbidity. Labor and delivery is a vulnerable time for pregnant individuals with CVD but there is significant ... Full text Cite

Maternal and Pregnancy Outcomes Following Heart Transplantation in the United States.

Journal Article JACC Heart Fail · December 2023 BACKGROUND: Improved survival following heart transplantation (HT) has led to more recipients contemplating pregnancy, but data on outcomes are limited. OBJECTIVES: The authors used a national data set to investigate and describe outcomes of pregnancies an ... Full text Link to item Cite

Severe Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Cardiomyopathies.

Journal Article JACC Heart Fail · December 2023 BACKGROUND: Women with cardiomyopathies are at risk for pregnancy complications. The optimal mode of delivery in these patients is guided by expert opinion and limited small studies. OBJECTIVES: The objective of this study is to examine the association of ... Full text Link to item Cite

In Response.

Journal Article Anesth Analg · December 1, 2023 Full text Link to item Cite

Racial and Rural-Urban Disparities in Maternal Cardiac Disease Care in North Carolina: A Call to Action

Journal Article North Carolina Medical Journal · July 5, 2023 BackgroundCardiac disease is a leading cause of severe maternal morbidity (SMM). We sought to estimate the effects of race and rural-urban status on cardiac-specific severe maternal morbidity (“c ... Full text Cite

Practice Advisory for Preoperative and Intraoperative Pain Management of Cardiac Surgical Patients: Part 2.

Journal Article Anesth Analg · July 1, 2023 Pain after cardiac surgery is of moderate to severe intensity, which increases postoperative distress and health care costs, and affects functional recovery. Opioids have been central agents in treating pain after cardiac surgery for decades. The use of mu ... Full text Link to item Cite

Practice Advisory for Preoperative and Intraoperative Pain Management of Thoracic Surgical Patients: Part 1.

Journal Article Anesth Analg · July 1, 2023 Pain after thoracic surgery is of moderate-to-severe intensity and can cause increased postoperative distress and affect functional recovery. Opioids have been central agents in treating pain after thoracic surgery for decades. The use of multimodal analge ... Full text Link to item Cite

Maternal Cardiovascular Morbidity Events Following Preeclampsia: A Retrospective Cohort Study.

Journal Article Anesth Analg · April 1, 2023 BACKGROUND: Patients with preeclampsia are at high risk for long-term cardiovascular events, yet the short-term, acute cardiovascular complications that follow preeclampsia are understudied. The objective of this study was to compare the short-term, acute ... Full text Link to item Cite

Anesthetic Care of the Pregnant Patient With Cardiovascular Disease: A Scientific Statement From the American Heart Association.

Journal Article Circulation · March 14, 2023 The pregnancy-related mortality rate in the United States is excessively high. The American Heart Association is dedicated to fighting heart disease and recognizes that cardiovascular disease, preexisting or acquired during pregnancy, is the leading cause ... Full text Link to item Cite

Pregnancy-Associated Extracorporeal Membrane Oxygenation in the United States.

Journal Article Am J Perinatol · February 15, 2023 OBJECTIVE:  The use of extracorporeal membrane oxygenation (ECMO) therapy has increased in the adult population. Studies from the H1N1 influenza pandemic suggest that ECMO deployment in pregnancy is associated with favorable outcomes. With increasing numbe ... Full text Link to item Cite

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava.

Journal Article J Vis Exp · January 13, 2023 Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical decision-making. Among the applications of POCUS, imaging the inferior vena cava (IVC) is practiced by a wide varie ... Full text Link to item Cite

For better care we need better data: towards a national obstetrics registry.

Journal Article Am J Obstet Gynecol MFM · January 2023 Unacceptably high rates of severe maternal morbidity and mortality in the United States and stark racial disparities in outcomes are generating efforts to improve both research capacity and quality improvement in obstetrical care. Comprehensive, high-quali ... Full text Link to item Cite

Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Pulmonary Hypertension.

Journal Article Anesth Analg · May 1, 2024 BACKGROUND: Patients with pulmonary hypertension have a high risk of maternal morbidity and mortality. It is unknown if a trial of labor carries a lower risk of morbidity in these patients compared to a planned cesarean delivery. The objective of this stud ... Full text Link to item Cite

Hospital Discharge Codes and Overestimating Severe Maternal Morbidity During Delivery Hospitalization.

Journal Article Obstetrics and gynecology · April 2024 Our objective was to identify birth hospitalization severe maternal morbidity (SMM) diagnoses that were also coded during prior encounters and, thus, potentially falsely carried forward as de novo SMM events. This retrospective cohort study included pregna ... Full text Cite

Recommendations for the Management of High-Risk Cardiac Delivery: ACC Cardiovascular Disease in Women Committee Panel

Journal Article JACC: Advances · April 1, 2024 Maternal mortality is a major public health crisis in the United States. Cardiovascular disease (CVD) is a leading cause of maternal mortality and morbidity. Labor and delivery is a vulnerable time for pregnant individuals with CVD but there is significant ... Full text Cite

Maternal and Pregnancy Outcomes Following Heart Transplantation in the United States.

Journal Article JACC Heart Fail · December 2023 BACKGROUND: Improved survival following heart transplantation (HT) has led to more recipients contemplating pregnancy, but data on outcomes are limited. OBJECTIVES: The authors used a national data set to investigate and describe outcomes of pregnancies an ... Full text Link to item Cite

Severe Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Cardiomyopathies.

Journal Article JACC Heart Fail · December 2023 BACKGROUND: Women with cardiomyopathies are at risk for pregnancy complications. The optimal mode of delivery in these patients is guided by expert opinion and limited small studies. OBJECTIVES: The objective of this study is to examine the association of ... Full text Link to item Cite

In Response.

Journal Article Anesth Analg · December 1, 2023 Full text Link to item Cite

Racial and Rural-Urban Disparities in Maternal Cardiac Disease Care in North Carolina: A Call to Action

Journal Article North Carolina Medical Journal · July 5, 2023 BackgroundCardiac disease is a leading cause of severe maternal morbidity (SMM). We sought to estimate the effects of race and rural-urban status on cardiac-specific severe maternal morbidity (“c ... Full text Cite

Practice Advisory for Preoperative and Intraoperative Pain Management of Cardiac Surgical Patients: Part 2.

Journal Article Anesth Analg · July 1, 2023 Pain after cardiac surgery is of moderate to severe intensity, which increases postoperative distress and health care costs, and affects functional recovery. Opioids have been central agents in treating pain after cardiac surgery for decades. The use of mu ... Full text Link to item Cite

Practice Advisory for Preoperative and Intraoperative Pain Management of Thoracic Surgical Patients: Part 1.

Journal Article Anesth Analg · July 1, 2023 Pain after thoracic surgery is of moderate-to-severe intensity and can cause increased postoperative distress and affect functional recovery. Opioids have been central agents in treating pain after thoracic surgery for decades. The use of multimodal analge ... Full text Link to item Cite

Maternal Cardiovascular Morbidity Events Following Preeclampsia: A Retrospective Cohort Study.

Journal Article Anesth Analg · April 1, 2023 BACKGROUND: Patients with preeclampsia are at high risk for long-term cardiovascular events, yet the short-term, acute cardiovascular complications that follow preeclampsia are understudied. The objective of this study was to compare the short-term, acute ... Full text Link to item Cite

Anesthetic Care of the Pregnant Patient With Cardiovascular Disease: A Scientific Statement From the American Heart Association.

Journal Article Circulation · March 14, 2023 The pregnancy-related mortality rate in the United States is excessively high. The American Heart Association is dedicated to fighting heart disease and recognizes that cardiovascular disease, preexisting or acquired during pregnancy, is the leading cause ... Full text Link to item Cite

Pregnancy-Associated Extracorporeal Membrane Oxygenation in the United States.

Journal Article Am J Perinatol · February 15, 2023 OBJECTIVE:  The use of extracorporeal membrane oxygenation (ECMO) therapy has increased in the adult population. Studies from the H1N1 influenza pandemic suggest that ECMO deployment in pregnancy is associated with favorable outcomes. With increasing numbe ... Full text Link to item Cite

Image Acquisition Method for the Sonographic Assessment of the Inferior Vena Cava.

Journal Article J Vis Exp · January 13, 2023 Over the past several decades, clinicians have incorporated several applications of diagnostic point-of-care ultrasound (POCUS) into medical decision-making. Among the applications of POCUS, imaging the inferior vena cava (IVC) is practiced by a wide varie ... Full text Link to item Cite

For better care we need better data: towards a national obstetrics registry.

Journal Article Am J Obstet Gynecol MFM · January 2023 Unacceptably high rates of severe maternal morbidity and mortality in the United States and stark racial disparities in outcomes are generating efforts to improve both research capacity and quality improvement in obstetrical care. Comprehensive, high-quali ... Full text Link to item Cite

Incidence of severe maternal morbidity by race and payer status at an academic medical system

Conference AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2022 Cite

Extracorporeal Membrane Oxygenation does not confer excess risk in Pregnancy

Conference AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2022 Cite

Pulmonary hypertension in pregnancy-the Anesthesiologist's perspective

Journal Article International Journal of Cardiology Congenital Heart Disease · October 2021 Full text Cite

Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations.

Journal Article Anesthesiology · July 1, 2021 Maternal morbidity and mortality as a result of cardiac disease is increasing in the United States. Safe management of pregnancy in women with heart disease requires appropriate anesthetic, cardiac, and obstetric care. The anesthesiologist should risk stra ... Full text Open Access Link to item Cite

Introduction of an Analgesia Prescription Guideline Can Reduce Unused Opioids After Cardiac Surgery: A Before and After Cohort Study.

Journal Article J Cardiothorac Vasc Anesth · June 2021 OBJECTIVE(S): The authors aimed to assess whether the introduction of a tailored Analgesia Prescription Guideline would decrease the amount of unused opioid following discharge from cardiac surgery. DESIGN: Prospective, observational, before and after stud ... Full text Link to item Cite

Peripartum considerations for women with cardiac disease.

Journal Article Curr Opin Anaesthesiol · June 1, 2021 PURPOSE OF REVIEW: The aim of this review of cardiac disease in pregnancy is to delineate current best practices and highlight emerging themes in the literature. RECENT FINDINGS: Cardiovascular disease is the leading cause of death among pregnant women in ... Full text Link to item Cite

Pulmonary hypertension and pregnancy: a preliminary report of 25 pregnancies

Conference AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2021 Cite

Check the Blood Pressure!: An Educational Tool for Anesthesiology Trainees Converting Epidural Labor Analgesia to Cesarean Delivery Anesthesia.

Journal Article A A Pract · April 2020 Recognition and treatment of maternal hypotension during epidural anesthesia administration for intrapartum cesarean delivery preserves maternal-fetal perfusion. A case that required quality assurance review uncovered lapses in maternal hemodynamic monitor ... Full text Link to item Cite

Adding to the Denominator: A Case Report of Neuraxial Anesthesia for Cesarean Delivery in the Setting of Hemolysis, Elevated Liver Enzyme, Low Platelet, Thrombocytopenia, and Pulmonary Hypertension.

Journal Article A A Pract · March 1, 2020 The acceptable platelet count for the safe provision of neuraxial anesthesia in obstetric patients is unknown. Comorbidities may sway a provider to perform neuraxial anesthesia, despite thrombocytopenia, as the putative risk of spinal-epidural hematoma may ... Full text Link to item Cite

How low did we go? A case report of unexpected thrombocytopenia.

Journal Article Int J Obstet Anesth · May 2019 We report the case of a normotensive 31-year-old parturient who received combined spinal-epidural analgesia for early labor, and who was then found to have an unexpectedly low platelet count (25 000/μL) with elevated liver enzymes, but without alterations ... Full text Link to item Cite

Eisenmenger Syndrome in Pregnancy: When Is It Time for ECMO?: A Case Report.

Journal Article A A Pract · November 15, 2018 We report the case of a 21-year-old primiparous woman at 22 weeks gestation who presented with a large uncorrected ventricular septal defect, severe pulmonary hypertension, and Eisenmenger syndrome. The patient elected for termination of pregnancy, which w ... Full text Link to item Cite

A study of factors influencing surgical cesarean delivery times in an academic tertiary center.

Journal Article Int J Obstet Anesth · May 2018 BACKGROUND: Knowledge of hospital-specific average cesarean delivery operative times, and factors influencing length of surgery, can serve as a guide for anesthesiologists when choosing the optimal anesthetic technique. The aim of this study was to determi ... Full text Link to item Cite

Anesthetic management of the patient with extracorporeal membrane oxygenator support.

Journal Article Best Pract Res Clin Anaesthesiol · June 2017 The use of short-term mechanical circulatory support in the form of extracorporeal membrane oxygenation (ECMO) in adult patients has increased over the last decade. Cardiothoracic anesthesiologists may care for these patients during ECMO placement and for ... Full text Link to item Cite

Anesthetic management of the patient with a ventricular assist device.

Journal Article Best Pract Res Clin Anaesthesiol · June 2017 The use of long- and short-term mechanical circulatory support in the form of ventricular assist device (VAD) has increased over the last decade. Although cardiothoracic anesthesiologists care for these patients during device placement, increasingly higher ... Full text Link to item Cite

Pulmonary Hypertension in Pregnancy: A Report of 49 Cases at Four Tertiary North American Sites.

Journal Article Obstet Gynecol · March 2017 OBJECTIVE: To identify whether pregnancy outcomes vary by etiology and severity of pulmonary hypertension and whether contemporary therapies influence outcomes. METHODS: A retrospective review of medical records at four academic institutions was conducted ... Full text Link to item Cite

Modern Neuraxial Anesthesia for Labor and Delivery.

Journal Article F1000Res · 2017 The availability of safe, effective analgesia during labor has become an expectation for women in most of the developed world over the past two or three decades. More than 60% of women in the United States now receive some kind of neuraxial procedure durin ... Full text Link to item Cite

Racial and Rural-Urban Disparities in Maternal Cardiac Disease Care in North Carolina: A Call to Action

Conference Background: Cardiac disease is a leading cause of severe maternal morbidity (SMM). We investigated deliveries among North Carolina individuals with preexisting heart disease and assessed outcomes by race and rural-urban status. Methods: This retrospective ... Cite