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]

Echocardiography

There is a progressive increase in chamber dimension with approximately a 20% increase in the size of the right atrium and the right ventricle, a 12% increase in left atrial size, and a 6% increase in left ventricular size. Postpartum, the changes gradually returned to 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

Indications:

Patients at high-risk for structural heart disease:

• women with a history of congenital heart disease themselves or in previous children
• diabetes and collagen vascular disease predispose to congenital heart disease
• a history of a fetal arrhythmia
• consumption of teratogens

Fetal Echo:

• one study found a sensitivity of 96% in detecting major structural malformations (72/74 abnormalities identified among 1,022 fetuses)
• useful for management during pregnancy, postpartum, and genetics counseling

References

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