Hostname: page-component-848d4c4894-4rdrl Total loading time: 0 Render date: 2024-06-17T02:58:52.310Z Has data issue: false hasContentIssue false

Maternal cardiac disease and pregnancy

Published online by Cambridge University Press:  10 October 2008

Frederik K Lotgering*
Affiliation:
Department of Obstetrics and Gynaecology, Erasmus University School of Medicine and Health Sciences, Rotterdam, The Netherlands.
*
FK Lotgering MD PhD, Dept OB/GYN, EE 2283, Erasmus University School of medicine and Health Sciences, PO Box 1738, 3000 DR Rotterdam, The Netherlands.

Extract

A woman with heart disease may benefit from early obstetric counselling because it may help to reduce uncertainty or anxiety with regard to her ability to carry a pregnancy at some time in her life and may help her to prevent unwanted pregnancy or to avoid the need for an abortion. Pregnancy imposes an additional burden upon the circulation of a woman with heart disease and additional precautions may therefore be required during the antenatal period, labour, delivery and the puerperium. Nevertheless, with proper care, maternal and fetal outcome is good in most women with cardiac disease.

Type
Articles
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Bitsch, M, Johansen, C, Wennevold, A, Osler, M. Maternal heart disease. A survey of a decade in a Danish university hospital. Acta Obstet Gynecol Scand 1989; 68: 119–24.CrossRefGoogle Scholar
2Sachs, BP, Brown, DAJ, Driscoll, SG, Schulman, E, Acker, D, Ransil, BJ et al. Hemorrhage, infection, toxemia and cardiac disease, 1954–85: causes for their declining role in maternal mortality. Am J Publ Health 1988; 78: 671–75.CrossRefGoogle ScholarPubMed
3Perloff, JK. Congenital heart diseases. In: Gleicher, N ed. Principles and practice of medical therapy in pregnancy, 2nd edition. Norwalk: Appleton, 1992; 788–94.Google Scholar
4Clapp, JF. Cardiac output and uterine blood flow in the pregnant ewe. Am J Obstet Gynecol 1978; 130: 419–23.CrossRefGoogle ScholarPubMed
5Wallenburg, HCS. Maternal haemodynamics in pregnancy. Fetal Med Rev 1990; 2: 4566.Google Scholar
6Longo, LD. Maternal blood volume and cardiac output during pregnancy: a hypothesis of endocrinologic control. Am J Physiol 1983; 245: R72029.Google Scholar
7Clark, SL, Cotton, DB, Lee, W, Bishop, C, Hill, T, Southwick, J et al. Central hemodynamic assessment of normal human pregnancy. Am J Obstet Gynecol 1989; 161: 1439–42.Google Scholar
8Ueland, K, Hausen, JM. Maternal cardiovascular dynamics. II. Posture and uterine contractions. Am J Obstet Gynecol 1969; 103: 17.CrossRefGoogle ScholarPubMed
9Kerr, MG. The mechanical effects of the gravid uterus in late pregnancy. J Obstet GynaecolBr Commonw 1965; 72: 513–29.Google Scholar
10Lotgering, FK, Wallenburg, HCS. Hemodynamic effects of caval and uterine venous occlusion in pregnant sheep. Am J Obstet Gynecol 1986; 155: 1164–70.Google Scholar
11Lotgering, FK, van Doorn, MB, Struijk, PC, Pool, J, Wallenburg, HCS. Maximal aerobic exercise in pregnant women: heart rate, O2 consumption, CO2 production, and ventilation. J Appl Physiol 1991; 70: 1016–23.CrossRefGoogle ScholarPubMed
12Sady, SP, Carpenter, MW, Thompson, PD, Sady, MA, Haydon, B, Coustan, DR. Cardiovascular response to cycle exercise during and after pregnancy. J Appl Physiol 1989; 66: 336–41.Google Scholar
13Van Doorn, MB, Lotgering, FK, Struijk, PC, Pool, J, Wallenburg, HCS. Maternal and fetal cardiovascular responses to strenuous bicycle exercise. Am J Obstet Gynecol 1992; 166: 854–59.Google Scholar
14Lotgering, FK, van den Berg, A, Struijk, PC, Wallenburg, HCS. Arterial pressure response to maximal isometric exercise in pregnant women. Am J Obstet Gynecol 1992; 166: 538–42.Google Scholar
15Pitkin, RM, Perloff, JK, Koos, BJ, Beall, MH. Pregnancy and congenital heart disease. Ann Int Med 1990; 112: 445–54.CrossRefGoogle ScholarPubMed
16Robbe, H. Physical working capacity, blood volume and heart volume in cardiac patients during and after pregnancy. Acta Obstet Gynecol Scand 1959; 38: 161.Google Scholar
17Von Dohrn, K. Die Bedeutung der Fahrradergometrie für die Festlegung der klinischen Schweregrades einer Herzerkrankung in der Schwangerschaft. Zbl Gynäkol 1985; 107: 478–84.Google Scholar
18Ramin, S, Maberry, MC, Gilstrap, LC. Congenital heart disease. Clin Obstet Gynecol 1989; 32: 4147.Google Scholar
19Clark, SL. Cardiac disease in pregnancy. Obstet Gynecol Clin North Am 1991; 18: 237–56.CrossRefGoogle ScholarPubMed
20Lynch-Salamon, DI, Maze, SS, Combs, CA. Pregnancy after Mustard repair for transposition of the great vessels. Obstet Gynecol 1993; 82: 676–79.Google Scholar
21Lin, AE, Garver, KL. Genetic counselling for congenital heart defects. J Pediatr 1988; 113: 1105–109.Google Scholar
22Stewart, PA. Echocardiography in the human fetus Doctoral thesis. Erasmus University, Rotterdam, 1989.Google Scholar
23Allen, LD, Chita, SK, Sharland, GK, Fagg, NLK, Anderson, RH, Crawford, DC. The accuracy of fetal echocardiography in the diagnosis of congenital heart disease. Int J Cardiol 1989; 25: 279–88.Google Scholar
24McFaul, PB, Dornan, JC, Lamki, H, Boyle, D. Pregnancy complicated by maternal heart disease. A review of 519 women. Br J Obstet Gynaecol 1988; 95: 861–67.Google Scholar
25Hands, ME, Johnson, MD, Saltzman, DH, Rutherford, JD. The cardiac, obstetric and anesthetic management of pregnancy complicated by acute myocardial infarction. J Clin Anesth 1990; 2: 258–68.Google Scholar
26Hankins, GDV, Wendel, GD, Leveno, KJ, Stoneham, J. Myocardial infarction during pregnancy: a review. Obstet Gynecol 1985; 65: 139–46.Google Scholar
27Verkaaik, APK, Visser, W, Deckers, JW, Lotgering, FK. Multiple coronary dissections in a women at term. Br J Anaesth 1993; 71: 301302.Google Scholar
28Dawson, PJ, Ross, AW. Preeclampsia in a parturient with a history of myocardial infarction. Anaesthesia 1988; 43: 659–63.Google Scholar
29Frenkel, Y, Barkai, G, Reisin, L, Rath, S, Mashiach, S, Battler, A. Pregnancy after myocardial infarction: are we safe?. Obstet Gynecol 1991; 77: 822–25.Google Scholar
30Brown, CEL, Wendel, GD. Cardiac arrhythmias during pregnancy. Clin Obstet Gynecol 1989; 32: 89102.Google Scholar
31Widerhorn, J, Rahimtoola, SH, Elkayam, U. Cardiac rhythm disorders. In: Gleicher, N ed, Principles and practice of medical therapy in pregnancy, 2nd edition. Norwalk: Appleton, 1992; 826–33.Google Scholar
32Shah, DM, Sunderji, SG. Hypertrophic cardiomyopathy and pregnancy: Report of a maternal mortality and review of the literature. Obstet Gynecol Survey 1985; 40: 444–48.Google Scholar
33Lee, W, Cotton, DB. Peripartum cardiomyopathy: current concepts and clinical management. Clin Obstet Gynecol 1989; 32: 5467.Google Scholar
34Veille, J-C. Peripartum cardiomyopathies: a review. Am J Obstet Gynecol 1984; 148: 805–18.CrossRefGoogle ScholarPubMed
35Demakis, JG, Rahimtoola, SH, Sutton, GC, Meadows, R, Szanto, PB, Robin, JR et al. Natural course of peripartum cardiomyopathy. Circulation 1971; 44: 964–68.Google Scholar
36Kirk, EP. Organ transplantation and pregnancy. A case report and review. Am J Obstet Gynecol 1991; 164: 1629–34.CrossRefGoogle ScholarPubMed
37Löwenstein, BR, Vain, NW, Perrone, SV, Wright, DR, Boullón, FJ, Favaloro, RG. Successful pregnancy and vaginal delivery after heart transplantation. Am J Obstet Gynecol 1988; 158: 589–90.Google Scholar
38Kossoy, LR, Herbert, CM III, Wentz, AC. Management of heart transplant recipients: guidelines for the obstetrician-gynecologist. Am J Obstet Gynecol, 1988; 159: 490–99.Google Scholar
39Bernal, JM, Miralles, PJ. Cardiac surgery with cardiopulmonary bypass during pregnancy. Obstet Gynecol Survey, 1986; 41: 16.CrossRefGoogle ScholarPubMed
40Koh, KS, Friesen, RM, Livingstone, RA, Peddle, LJ, Fetal monitoring during maternal cardiac surgery with cardiopulmonary bypass. CMA, 1975; 112: 1102–104.Google Scholar
41Werch, A, Lambert, HM, Cooley, D, Reed, CC, Fetal monitoring and open heart surgery, South Med J, 1977; 70: 1024.Google Scholar
42Lamb, MP, Ross, K, Johnson, AM, Manners, JM. Fetal monitoring during open heart surgery. Two case reports. Br J Obstet Gynaecol, 1981; 88: 669–74.CrossRefGoogle ScholarPubMed
43Mitani, GM, Steinberg, I, Lien, EJ, Harrison, EC, Elkayan, U, The pharmacokinetics of antiarrhythmic agents in pregnancy and laction Clin Pharmacokinet, 1987; 12: 253–91.CrossRefGoogle Scholar
44Hall, JG, Pauli, RM, Wilson, KM. Maternal and fetal sequelae of anticoagulation during pregnancy, Am J Med 1980; 68: 122–40.CrossRefGoogle ScholarPubMed
45Little, BB, Gilstrap, LC, Cardiovascular drugs during pregnancy, Clin Obstet Gynecol, 1989; 32: 1320.Google Scholar
46Piper, JM, Baum, C, Kennedy, DL, Price, P, Maternal use of prescribed drugs associated with recognized fetal adverse drug reactions, Am J Obstet Gynecol, 1988; 159: 1173–77.Google Scholar
47Shattock, MJ, Hearse, DJ, Fry, CH, The ionic basis of the anti-ischemic and anti arrhymic properties of magnesium in the heart, J Am Coll Nutr 1987; 6: 2733.CrossRefGoogle Scholar
48Read, MD, Welby, DE, The use of a calcium antagonist (nifedipine) to suppress preterm labor, Br J Obstet Gynaecol, 1986; 93: 933–37.Google Scholar
49Sugrue, D, Blake, S, Truy, P, macDonald, D, Antibiotic prophylaxis against infective endocarditis after normal delivery-is it necessary?, Br Heart J, 1980; 44: 499502.CrossRefGoogle ScholarPubMed
50Derman, R. Oral contraceptive in a reassessment, Obstet Gynecol Survey, 1989; 44: 662–68.Google Scholar
51Realini, JP, Goldzieher, JW, Oral contraceptives and cardiovascular disease: a critique of the epidemiologic studies, Am J Obstet Gynecol, 1985; 152: 729–98.CrossRefGoogle ScholarPubMed
52Meade, TWM. Risks and mechanisms of cardiovascular events in users of oral contraceptives. Am J Obstet Gynecol 1988; 158: 1646–52.Google Scholar
53Bogers, JW, Huikeshoven, FJM, Lotgering, FK, Complication of anticoagulant therapy in ovulatory women. Lancet 1991; 337: 618–19.Google Scholar