Cardiac interventions in pregnancy and peripartum – a narrative review of the literature

In the UK, mortality rate during pregnancy/in the peripartal period is 14.1 per 100,000 maternities with heart disease being the leading cause of non-obstetric maternal mortality (10% to 15% of all maternal deaths). Owing to the advances in the treatment of congenital heart disease (CHD), an increasing percentage of women has reached childbearing age, making CHD nowadays the most frequent cardiovascular disease during pregnancy in the Western world. In the pregnant woman, several adaptive changes occur in the cardiovascular and pulmonary system that in the worst case can lead to cardiovascular collapse in women with pre-existing heart disease.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Review Article Source Type: research

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Abstract Successful management of a pregnant patient with complex congenital heart disease is a challenge for anesthesiologists, requiring thorough knowledge of the impact of pregnancy on the cardiac lesion. Hearing and speech impaired patients pose a barrier to effective communication between the patient and the doctors, thus increasing the anxiety and risk of complications. Here, we present a case of a hearing and speech impaired woman with the rare and dangerous Eisenmenger's syndrome, presenting for an emergency cesarean section (CS). PMID: 31929258 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
This study aimed to assess the associations of pregnancy loss and risk of hypertension, type 2 diabetes (T2D), and hypercholesterolemia.
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mother, Fetus, Neonate Source Type: research
This report is the first instance in which a patient with severe PAH, survived a successful atrial septal defect (ASD) repair and bilateral lung transplantation during puerperium. Patient concerns: A 42-year-old pregnant woman with congenital heart disease (CHD) and severe PAH was admitted to our hospital for the management of pregnancy and delivery. The patient was diagnosed with severe PAH in 2013, and no significant improvements or deteriorations were found until this pregnancy-related hospital admission. Diagnosis: The patient was diagnosed with CHD and severe PAH in 2013 with color Doppler echocardiography, righ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Rationale: Coronary angiography (CAG) findings of acute myocardial infarction (AMI) in pregnant women are characterized by a high incidence of normal coronary arteries. This is the first report of AMI with normal coronary arteries during pregnancy, showing coronary spasm and pregnancy-related acquired protein S (PS) deficiency. Patient concerns: A 30-year-old Japanese woman was admitted to an emergency department. One hour before admission, she developed sudden onset of precordial discomfort, back pain, and dyspnea. She was a primigravida at 39 weeks’ gestation and had no abnormality in the pregnancy thus far. S...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Abstract Pulmonary hypertension is a term used to describe a complex multifactorial group of conditions diagnosed by an elevated mean pulmonary artery pressure of 20 mm Hg or higher on right heart catheterization. The diagnosis of pulmonary hypertension in pregnancy is important, as it is associated with high rates of maternal morbidity and mortality, even with modern management. Diagnostic testing is important for establishing the diagnosis, type, and severity of pulmonary hypertension, which in turn, dictates treatment options. Echocardiographic assessment is the first step in diagnosis and the gold standard for...
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
Conclusions: Multidisciplinary approaches are necessary from obstetricians, cardiologists, anesthesiologists and perinatologists for pregnancy monitoring and delivery outcomes. PMID: 31569595 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Publication date: Available online 20 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Amanda Zacharzewski, Ross MacnabAbstractCardiac disease is a significant cause of maternal mortality. In the UK in the last maternal mortality report, it was the leading cause of indirect maternal deaths (2.39 deaths per 100,000 maternities). The overall rate of maternal mortality from cardiac disease has significantly increased over the last three decades, with this increase being mostly attributable to deaths from ischaemic heart disease, myocardial infarction and peripartum cardiomyopathy. Conditions such as pulmo...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
[Relevant aspects of the ESC guidelines for the management of cardiovascular diseases during pregnancy for obstetric anaesthesia (update 2018)]. Anaesthesist. 2019 Jul 02;: Authors: Brück S, Seeland U, Kranke E, Kranke P Abstract The current update of the ESC (European Society of Cardiology) guidelines on managing cardiovascular diseases during pregnancy provides instructions for doctors in daily practice. Heart diseases are the most common reason for maternal death during pregnancy in western countries. Among other things, the following topics are dealt with: congenital heart disease, pulmo...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
Our story.... to begin with....is no different from many infertile couples. A perfect love marriage in 2005 with everyone's blessing after 5 years of courtship! As we began this exciting journey of togetherness, atage of 23,conscious decision was made not to start a family until be both settle well in careers, have a house of our own and descent earning to support a good standard of living. Years passed by fast and we were all set by 2009 to begin 'trying' for a baby with a confidence to be conceiving soon.....2010 came, with no success after trying for almost a year. The doctor in me alerted myown self that...
Source: Dr.Malpani's Blog - Category: Reproduction Medicine Source Type: blogs
Our story.... to begin with....is no different from many infertile couples. A perfect love marriage in 2005 with everyone's blessing after 5 years of courtship! As we began this exciting journey of togetherness, atage of 23,conscious decision was made not to start a family until be both settle well in careers, have a house of our own and descent earning to support a good standard of living. Years passed by fast and we were all set by 2009 to begin 'trying' for a baby with a confidence to be conceiving soon.....2010 came, with no success after trying for almost a year. The doctor in me alerted myown self that...
Source: Dr.Malpani's Blog - Category: Reproduction Medicine Source Type: blogs
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