Cardiac disease in pregnancy overview
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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 involve maternal cardiovascular disease.
- With a careful pre-pregnancy evaluation, most women with cardiovascular disease can have a pregnancy with proper care.
- Pregnancy can "unmask" underlying cardiovascular disease, due to hemodynamic changes associated with pregnancy.[1]
- Maternal cardiovascular disease includes (most commonly) congenital disease, dilated and hypertrophic cardiomyopathies, valvular disease (with as mitral valve prolapse), pulmonary hypertension, and coronary disease. cardiac disease is now congenital in origin. Other cardiovascular problems seen include cardiomyopathies, both dilated and hypertrophic, and valvular disease, such as bicuspid aortic valve and mitral valve prolapse. Less common problems include pulmonary hypertension and, rarely, coronary artery disease. Any of the above require a strategy regarding the frequency of follow-up by the cardiologist and a plan for labor and delivery.[2][2]
- Siu et al. have developed a risk score for pregnant women with cardiovascular disease, and found that prior cardiac events or arrhythmia, poor functional class or cyanosis, left heart obstruction, and left ventricular systolic dysfunction independently predicted maternal cardiac complications.[3]
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.
- ↑ 2.0 2.1 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.