Cardiac disease in pregnancy overview: Difference between revisions
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==Disorders Associated with Cardiovascular Disease in Pregnancy== | ==Disorders Associated with Cardiovascular Disease in Pregnancy== | ||
Maternal cardiovascular disease includes (most commonly) congenital heart disease. Other cardiovascular disorders encountered during pregnancy include [[cardiomyopathies]], both [[dilated cardiomyopathy|dilated]] and [[hypertrophic obstructive cardiomyopathy|hypertrophic]], and valvular heart disease, such as [[bicuspid aortic valve]] and [[mitral valve prolapse]]. Less common cardiovascular disorders include [[pulmonary hypertension]] and, rarely, [[coronary artery disease]]. The above cardiovascular disorders require a strategy regarding the frequency of follow-up by the cardiologist and a plan for labor and delivery.<ref name="pmid15020530">{{cite journal| author=Thorne SA| title=Pregnancy in heart disease. | journal=Heart | year= 2004 | volume= 90 | issue= 4 | pages= 450-6 | pmid=15020530 | doi= | pmc=PMC1768170 | url= }} </ref> | Maternal cardiovascular disease includes (most commonly) [[congenital heart disease|Pregnancy and heart disease congenital heart disease]]. Other cardiovascular disorders encountered during pregnancy include [[Pregnancy and heart disease cardiomyopathies|cardiomyopathies]], both [[dilated cardiomyopathy|dilated]] and [[hypertrophic obstructive cardiomyopathy|hypertrophic]], and [[Pregnancy and heart disease valvular heart disease|valvular heart disease]], such as [[bicuspid aortic valve]] and [[mitral valve prolapse]]. Less common cardiovascular disorders include [[Pregnancy and heart disease pulmonary hypertension|pulmonary hypertension]] and, rarely, [[Pregnancy and heart disease coronary artery disease|coronary artery disease]]. The above cardiovascular disorders require a strategy regarding the frequency of follow-up by the cardiologist and a plan for labor and delivery.<ref name="pmid15020530">{{cite journal| author=Thorne SA| title=Pregnancy in heart disease. | journal=Heart | year= 2004 | volume= 90 | issue= 4 | pages= 450-6 | pmid=15020530 | doi= | pmc=PMC1768170 | url= }} </ref> | ||
==Risk Factors== | ==Risk Factors== | ||
Revision as of 15:03, 25 October 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Anjan K. Chakrabarti, M.D. [2]
Overview
Approximately 1-4% of pregnancies in the United States occur in women with maternal cardiovascular disease. In fact, pregnancy can "unmask" underlying cardiovascular disease, due to the hemodynamic changes associated with pregnancy. [1] With a careful pre-pregnancy evaluation, most women with cardiovascular disease can carry a pregnancy to term with proper care.
Epidemiology and Demographics
Increasing numbers of women with congenital heart disease are now reaching childbearing age, making congenital heart disease the most common form of heart disease complicating pregnancy in the United States. Rheumatic heart disease is still prevalent in the developing world and in immigrant populations. Overall, maternal death during pregnancy in women with heart disease is rare, but certain conditions are associated with an increased mortality.[2]
Disorders Associated with Cardiovascular Disease in Pregnancy
Maternal cardiovascular disease includes (most commonly) Pregnancy and heart disease congenital heart disease. Other cardiovascular disorders encountered during pregnancy include cardiomyopathies, both dilated and hypertrophic, and valvular heart disease, such as bicuspid aortic valve and mitral valve prolapse. Less common cardiovascular disorders include pulmonary hypertension and, rarely, coronary artery disease. The above cardiovascular disorders require a strategy regarding the frequency of follow-up by the cardiologist and a plan for labor and delivery.[3]
Risk Factors
The following clinical characteristics are independent predictors of adverse outcomes in a risk score for maternal cardiac complications[4]:
- Prior cardiac events or arrhythmia
- Poor functional class or cyanosis
- Left ventricular outflow tract obstruction
- Left ventricular systolic dysfunction
Pulmonary hypertension is a well recognized risk factor during maternal pregnancy. In particular the presence of Eisenmenger syndrome places the mother particularly high risk.
Diagnosis
Physical Examination
ECG
Echocardiography
Treatment
References
- ↑ Roos-Hesselink JW, Duvekot JJ, Thorne SA (2009). "Pregnancy in high risk cardiac conditions". Heart. 95 (8): 680–6. doi:10.1136/hrt.2008.148932. PMID 19329725.
- ↑ Siu SC, Colman JM (2001). "Heart disease and pregnancy". Heart. 85 (6): 710–5. PMC 1729784. PMID 11359761.
- ↑ Thorne SA (2004). "Pregnancy in heart disease". Heart. 90 (4): 450–6. PMC 1768170. PMID 15020530.
- ↑ Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC; et al. (2001). "Prospective multicenter study of pregnancy outcomes in women with heart disease". Circulation. 104 (5): 515–21. PMID 11479246.