Cardiology MCQ: Cardiovascular contraindication to pregnancy

Cardiovascular contraindication to pregnancy: a) Severe pulmonary hypertension b) Severe obstructive valvular lesions c) Marfan syndrome with dilated aorta d) All of the above Correct answer: d) All of the above Marfan syndrome with dilated aorta carries a high risk of aortic dissection during labour. Severe cyanotic congenital heart disease is another cardiovascular contraindication to pregnancy. In general obstructive lesions are poorly tolerated in pregnancy. Severe mitral stenosis can lead on to acute pulmonary edema during labour or in the immediate postpartum period. Pulmonary edema can occur earlier as well when the heart rate and blood volume increases towards term. Immediately after labour, during placental separation, blood from the maternal side of the placenta is pushed back into the maternal circulation, though some of it is lost as uterine bleed during placental separation. Blood held in the uterine circulation also gets back into the maternal circulation after labour as the uterus involutes. Both these can lead to pulmonary edema in severe mitral stenosis in the immediate postpartum period. Severe aortic stenosis also carries high risk in pregnancy because of the nearly fixed cardiac output, which cannot meet the extra demand during parturition. Similar situation exists in severe pulmonary hypertension due to obliterative pulmonary vascular disease. Due the high pulmonary vascular resistance, the cardiovascular system is unable to increase the cardiac output ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs