Download Pregnancy and Congenital Heart Disease by Jolien W. Roos-Hesselink, Mark R. Johnson PDF

By Jolien W. Roos-Hesselink, Mark R. Johnson

This publication describes the hazards dealing with sufferers with congenital center illness who desire to turn into pregnant and the ways that those sufferers can most sensible be and taken care of while pregnant. additionally, the association of care round the supply is mentioned intimately. the 1st part offers transparent suggestion on pre-pregnancy chance estimation, counseling of sufferers, drugs use, and inheritance. the explicit dangers linked to congenital center defects of differing severity are then defined, with advice on tracking and administration. The insurance contains easy lesions comparable to atrial and ventricular septal defects, stipulations linked to reasonable threat, together with tetralogy of Fallot and coarctation, and intricate ailment equivalent to a Fontan or Mustard fix. the ultimate part is dedicated to supply and considers the mode of supply, anesthetic use, and postpartum care. Readers will locate a lot info that's underreported within the literature, and the publication is going well past the eu Society of Cardiology directions, for instance, via contemplating health conditions no longer outlined as excessive danger and addressing the association of care thoroughly.

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Risk of arrhythmia, prevention of aortic dissection in patients with Marfan syndrome) [13]. They constitute two thirds of the cardiac medication used during pregnancy [43]. A large meta-analysis concluded that there is no increased risk of major congenital anomalies associated with beta-blocker use during the first trimester [57]. However, organ-specific analyses showed a possible small increased risk of cardiovascular defects, cleft lip/palate, and neural tube defects. Various studies indicated an association between the usage of beta-blockers and fetal growth restriction though causality is uncertain [11, 33, 35, 43].

Data from the European Registry on Pregnancy and Cardiac Disease (ROPAC) showed that the timing of heart failure was dependent on the nature of the underlying heart disease, with heart failure in the second trimester occurring in patients with shunt lesions or valvular heart disease. By contrast, patients with cardiomyopathy or ischemic heart disease developed heart failure shortly after delivery [44]. Common obstetric complications are hypertensive disorders of pregnancy and premature labor. The risk of these complications appears to be associated with the underlying congenital heart disease [9].

It can help to control menstrual bleeding problems which occur more often in women using anticoagulants [33–35]. While the natural menstrual cycle is maintained with copper IUDs, an increase in blood loss and discomfort are often observed with menstruation. The risk of pelvic infection is increased during the first 3 months after insertion, and transient bacteraemia has been documented at replacement but is rare in uncomplicated insertion or removal [36, 37]. Recent studies and guidelines do not recommend the standard use of prophylactic antibiotics to prevent either PID (pelvic inflammatory disease) or endocarditis at insertion [38–43].

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