Eisenmenger’s syndrome ACC/AHA guidelines for reproduction: Difference between revisions
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==ACC / AHA Guidelines- Recommendations for Reproduction (DO NOT EDIT)== | ==ACC / AHA Guidelines- Recommendations for Reproduction (DO NOT EDIT)== | ||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]= | {| class="wikitable" | ||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Women with severe CHD-PAH, especially those with Eisenmenger physiology, and their partners should be counseled about the absolute avoidance of pregnancy in view of the high risk of maternal death, and they should be educated regarding safe and appropriate methods of contraception. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Women with CHD-PAH who become pregnant should: | |||
a. Receive individualized counseling from cardiovascular and obstetric caregivers collaborating in care and with expertise in management of CHD-PAH. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' | |||
in | |||
b. Undergo the earliest possible pregnancy termination after such counseling. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]) | |||
(Level of Evidence: C) | |||
3. Surgical sterilization carries some operative risk for women with CHD-PAH but is a safer option than pregnancy. In view of advances in minimally invasive techniques, the risks and benefits of sterilization modalities should be discussed with an obstetrician experienced in | |||
management of high-risk patients, as well as with a cardiac anesthesiologist. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |||
{| class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightCoral"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] | |||
= | |- | ||
1. Pregnancy in women with CHD-PAH, especially those | | bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.'''Pregnancy in women with CHD-PAH, especially those with Eisenmenger physiology, is not recommended and should be absolutely avoided in view of the high risk of maternal mortality. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | ||
with Eisenmenger physiology, is not recommended and | |||
should be absolutely avoided in view of the high risk of | |||
maternal mortality. (Level of Evidence: B) | |||
2. The use of single-barrier contraception alone in women | |- | ||
with CHD-PAH is not recommended owing to the | | bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' The use of single-barrier contraception alone in women with CHD-PAH is not recommended owing to the frequency of failure. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
frequency of failure. (Level of Evidence: C) | |||
3. Estrogen-containing contraceptives should be avoided. | |- | ||
(Level of Evidence: C) | | bgcolor="LightCoral"|<nowiki>"</nowiki>'''3.''' Estrogen-containing contraceptives should be avoided.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | ||
|} | |||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]= | {| class="wikitable" | ||
1. Pregnancy termination in the last 2 trimesters of | |- | ||
pregnancy poses a high risk to the mother. It may be | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
reasonable, however, after the risks of termination are | |- | ||
balanced against the risks of continuation of the pregnancy. | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Pregnancy termination in the last 2 trimesters of pregnancy poses a high risk to the mother. It may be reasonable, however, after the risks of termination are balanced against the risks of continuation of the pregnancy. | ||
==References== | ==References== | ||
Revision as of 16:12, 9 October 2012
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Eisenmenger’s syndrome Microchapters |
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Diagnosis |
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Eisenmenger’s syndrome ACC/AHA Guidelines for Evaluation of Patients |
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Treatment |
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Eisenmenger’s syndrome ACC/AHA guidelines for reproduction On the Web |
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Risk calculators and risk factors for Eisenmenger’s syndrome ACC/AHA guidelines for reproduction |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Priyamavada Singh, MMBS [[3]]Assistant Editor-In-Chief: Kristin Feeney, B.S. [[4]]
Overview
ACC / AHA Guidelines- Recommendations for Reproduction (DO NOT EDIT)
| Class I | ||||||
| "1. Women with severe CHD-PAH, especially those with Eisenmenger physiology, and their partners should be counseled about the absolute avoidance of pregnancy in view of the high risk of maternal death, and they should be educated regarding safe and appropriate methods of contraception. (Level of Evidence: B) " | ||||||
| "2. Women with CHD-PAH who become pregnant should:
a. Receive individualized counseling from cardiovascular and obstetric caregivers collaborating in care and with expertise in management of CHD-PAH. (Level of Evidence: C) b. Undergo the earliest possible pregnancy termination after such counseling. (Level of Evidence: C) 3. Surgical sterilization carries some operative risk for women with CHD-PAH but is a safer option than pregnancy. In view of advances in minimally invasive techniques, the risks and benefits of sterilization modalities should be discussed with an obstetrician experienced in management of high-risk patients, as well as with a cardiac anesthesiologist. (Level of Evidence: C) "
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