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

Abstract:

: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. If medical management is not sufficient, cardiac interventions have to be considered, including percutaneous endovascular interventions, cardiac surgery, the use of extracorporeal membrane oxygenation or the placement of assist devices. While all these interventions seem to be relatively safe for the mother, fetal mortality remains considerably high. A thorough understanding of maternal physiology during pregnancy and of the perfusion of the feto-maternal unit is mandatory for the successful management of pregnant patients in need of cardiac (surgical) interventions.

authors

Carlier L,Devroe S,Budts W,Van Calsteren K,Rega F,Van de Velde M,Rex S

doi

10.1053/j.jvca.2019.12.021

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

3409-3419

issue

12

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(19)31275-3

journal_volume

34

pub_type

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