Cardiac disease in pregnancy echocardiography

Cardiac disease in pregnancy Microchapters
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Special Scenarios: I. Pre-existing Cardiac Disease: Congenital Heart Disease Repaired Congenital Heart Disease Pulmonary Hypertension Rheumatic Heart Disease Connective Tissue Disorders II. Valvular Heart Disease: Mitral Stenosis Mitral Regurgitation Aortic Insufficiency Aortic Stenosis Mechanical Prosthetic Valves Tissue Prosthetic Valves III. Cardiomyopathy: Dilated Cardiomyopathy Hypertrophic Cardiomyopathy Peripartum Cardiomyopathy IV. Cardiac diseases that may develop During Pregnancy: Arrhythmias Acute Myocardial Infarction Hypertension
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Lakshmi Gopalakrishnan, M.B.B.S. [3]

Overview

Echocardiograhy does not carry the risk of fetal irradiation; hence, is a safe and preferred screening method to assess cardiac function and valvular lesions.

Maternal Echocardiographic Findings

• There is a progressive increase in chamber dimension with:

• ~20% increase in the size of the right atrium and the right ventricle,
• ~12% increase in left atrial size, and
• ~6% increase in left ventricular size.

• Following delivery, the above changes gradually return to pre-gestational baseline.

• In addition, there is early and progressive dilation of the mitral, tricuspid, and pulmonary annuli which is associated with an increase in valvular regurgitation.

Fetal Echocardiography

Fetal echocardiography is 96% sensitive in detecting major structural malformations (72/74 abnormalities identified among 1,022 fetuses) and is useful for genetics counseling and management during pregnancy and postpartum.

Indications:

• Pregnant women at high-risk for structural heart disease with:

• History of congenital heart disease themselves or in previous children.
• Presence of diabetes or collagen vascular disease- predisposing factor for congenital heart disease.

• History of a fetal arrhythmia
• Consumption of teratogens

References

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