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Section 4 - The pregnant patient with coexisting disease

Published online by Cambridge University Press:  05 July 2013

Marc van de Velde
Affiliation:
University Hospital Leuven
Helen Scholefield
Affiliation:
Liverpool Women's Hospital
Lauren A. Plante
Affiliation:
Drexel University College of Medicine
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Summary

The spectrum of cardiovascular disease presenting during pregnancy is evolving and differs according to geographical conditions. Several risk scoring systems have been developed and represent easily identifiable hemodynamic predictors for maternal and/or fetal risk. If heart failure occurs, management should be as for non-pregnant patients, with prescription of diuretics to relieve congestion, and beta-blockers for afterload reduction and modulation of sympathomimetic tone. Mitral stenosis accounts for most of the morbidity and mortality of rheumatic disease during pregnancy and is mostly encountered in the developing world. There is a broad spectrum of congenital abnormalities and therefore a wide range of risk associated with pregnancy, from a risk similar to the normal population (e.g. mild pulmonary stenosis) up to very high-risk conditions such as the Eisenmenger syndrome. Acute coronary syndromes during pregnancy are rare events with an estimated prevalence of 3-6 per 100,000 deliveries.
Type
Chapter
Information
Maternal Critical Care
A Multidisciplinary Approach
, pp. 247 - 402
Publisher: Cambridge University Press
Print publication year: 2013

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