Pregnancy and Congenital Heart Disease: A Brief Review of Risk Assessment and Management.

Abstract:

:Cardiac disease is a leading cause of morbidity and mortality in pregnant women. An increased prevalence of the cardiovascular disease has been found in women of childbearing age, in which the responsibility of the treating physician extends to the mother and to the unborn fetus. As a result, care of these high-risk pregnant women with cardiovascular disease including those with congenital heart disease (CHD) require a team approach including specialists in maternal-fetal medicine, adult congenital cardiology, and obstetrical anesthesia. The human body undergoes significant amounts of physiological changes during this period of time and the underlying cardiac disease can affect both the mother and the fetus. Today, most female children born with CHD will reach childbearing age. For many women with complex CHD, carrying a pregnancy has a moderate to high risk for both the mother and her fetus. This chapter will review the epidemiology, risk factors, clinical presentation including common signs and symptoms, physiological changes in pregnancy, and the medical approach including cardiac medications, percutaneous interventions, and surgical procedures for pregnant women with CHD.

journal_name

Clin Obstet Gynecol

authors

Chan A,Wolfe DS,Zaidi AN

doi

10.1097/GRF.0000000000000579

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

836-851

issue

4

eissn

0009-9201

issn

1532-5520

pii

00003081-202012000-00016

journal_volume

63

pub_type

杂志文章
  • Ultrasound in the diagnosis of ectopic pregnancy.

    abstract::The majority of ectopic pregnancies can be diagnosed on transvaginal scan before treatment. Diagnosis should be based on positive visualization of an ectopic pregnancy rather the inability to visualize an intrauterine pregnancy. The majority of ectopic pregnancies will be visible on the initial transvaginal scan perfo...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e31824e35fe

    authors: Kirk E

    更新日期:2012-06-01 00:00:00

  • Reducing Maternal Mortality and Severe Maternal Morbidity Through State-based Quality Improvement Initiatives.

    abstract::State Perinatal Quality Collaboratives (PQCs) represent a major advance for scaling up quality improvement efforts for reducing maternal mortality and severe maternal morbidity. The critical roles of partners, rapid-cycle low-burden data systems, and linkage to maternal mortality review committees are reviewed. The ch...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0000000000000361

    authors: Main EK

    更新日期:2018-06-01 00:00:00

  • Ultrasound evaluation of the postdate pregnancy.

    abstract::In summary, ultrasound plays an important role in the evaluation of the postterm pregnancy, and its use should be considered in the following situations: 1) estimation of fetal weight in the potentially macrosomic infant before vaginal delivery is attempted; 2) frequent evaluation for oligohydramnios using the amnioti...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-198906000-00008

    authors: Rodriguez MH

    更新日期:1989-06-01 00:00:00

  • Dynamic ultrasound-based fetal assessment: the fetal biophysical profile score.

    abstract::The advent of ultrasound fetal imaging and the evolution of dynamic imaging (real-time) methods have opened great new vistas in which fetal responses can be monitored with remarkable precision and clarity. Contained within this new wealth of information may lie the key to direct determination of the fetus at risk for ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199503000-00006

    authors: Manning FA

    更新日期:1995-03-01 00:00:00

  • Induction of Labor and Cesarean: What is the True Relationship?

    abstract::It is a commonly held belief that labor induction increases the risk of cesarean delivery; women who are induced are at higher risk of cesarean as compared with those in spontaneous labor. This comparison group is inaccurate, however, as women and providers cannot choose spontaneous labor as the alternative to labor i...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000112

    authors: Little SE,Caughey AB

    更新日期:2015-06-01 00:00:00

  • Antepartum management of twin gestation: ultrasound.

    abstract::1. The use of ultrasound may improve perinatal outcome in twin pregnancy. 2. Singleton growth curves for FL, BPD, and AC may be used to assess fetal growth prior to 28 weeks gestation. 3. After 28 weeks gestation, specific twin growth curves should be used. However, increased morbidity may be seen when fetal weight fa...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199003000-00008

    authors: D'Alton ME,Mercer BM

    更新日期:1990-03-01 00:00:00

  • Antenatal therapy to minimize neonatal intraventricular hemorrhage.

    abstract::Periventricular-intraventricular hemorrhage is an important problem, resulting in significant mortality and morbidity. Attempts to reduce this complication require an understanding of its pathogenesis. In this chapter a model was proposed, consisting of a series of events resulting in rapid changes of cerebral blood f...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199106000-00014

    authors: Morales WJ

    更新日期:1991-06-01 00:00:00

  • The Utilization of Interventional Radiologic Procedures in the Surgical Management of Placenta Accreta Syndrome.

    abstract::The role of Interventional radiologic procedures for the management of suspected placenta accreta spectrum (PAS) has evolved considerably over last 3 decades. In this article, the authors describe the various techniques of vascular occlusion for the management of PAS and provide a brief review of the literature examin...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000401

    authors: Shrivastava VK,Nageotte MP

    更新日期:2018-12-01 00:00:00

  • Management of Preinvasive Lesions.

    abstract::Serous tubal intraepithelial carcinoma is considered the precursor lesion of high-grade serous carcinoma, and found in both low-risk and high-risk populations. Isolated serous tubal intraepithelial carcinomas in patients with BRCA1/2 mutations are detected in ∼2% of patients undergoing risk-reducing bilateral salpingo...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000316

    authors: Patrono MG,Corzo C,Iniesta M,Ramirez PT

    更新日期:2017-12-01 00:00:00

  • Robotic-assisted surgery for the community gynecologist: can it be adopted?

    abstract::The American College of Obstetricians and Gynecologists and the American Association of Gynecologic Laparoscopists confirm advantages of conventional minimally invasive surgery over laparotomy for benign gynecological procedures; however, adoption remains low for the general gynecologist. A systematic search for gynec...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e31822b4998

    authors: Payne TN,Pitter MC

    更新日期:2011-09-01 00:00:00

  • Plan A: postabortion contraception.

    abstract::More than 1 million abortions are performed annually in the United States. Women presenting for abortion care are often motivated by the pregnancy to use effective contraception; they are also at high risk for repeat unintended pregnancy. For these reasons, abortion represents an optimal time to initiate effective con...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000057

    authors: Micks E,Prager S

    更新日期:2014-12-01 00:00:00

  • Antenatal Management of Placenta Accreta.

    abstract::Predelivery diagnosis of placenta accreta, increta, and percreta (from here referred to as placenta accreta, unless otherwise noted) has increasingly created opportunities to optimize antenatal management. Despite the increased frequency of placenta accreta today, occurring in as many as 1 in 533 to 1 in 272 deliverie...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000394

    authors: Haunschild C,Yeaton-Massey A,Lyell DJ

    更新日期:2018-12-01 00:00:00

  • GnRH agonists.

    abstract::The development of GnRH agonists has had a major impact on the practice of gynecology and reproductive endocrinology. The clinical usefulness of GnRH agonists will increase as modes of administration are improved and indications become better defined. GnRH agonists and, potentially, antagonists will provide a prompt, ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-198909000-00019

    authors: Schriock ED

    更新日期:1989-09-01 00:00:00

  • Epidemiology and risk factors.

    abstract::HBC is common, accounting for approximately 9% of the total breast cancer burden. Given 142,000 cases of breast cancer expected to occur in 1989, this would represent 12,780 cases of HBC patients. Soberingly, each patient represents a family with a variable number of inordinately high risk patients. HBC's natural hist...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-198912000-00018

    authors: Lynch HT,Watson P,Lynch JF

    更新日期:1989-12-01 00:00:00

  • Atosiban.

    abstract::The role of oxytocin and oxytocin receptors in preterm labor is perhaps more prominent than once thought. The blockade of oxytocin and/or oxytocin receptors has both a theoretical and clinical aspect. Initial trials with the oxytocin antagonist atosiban have been encouraging with respect to efficacy and side effect pr...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199538040-00007

    authors: Shubert PJ

    更新日期:1995-12-01 00:00:00

  • Fetal evaluation by real-time imaging.

    abstract::The application of real-time imaging to the study of fetal morphology and function is an exciting advance. Rapid accurate study of fetal dynamics is possible with this apparently safe, noninvasive technique. Animal studies have revealed the general physiology of fetal breathing movements, which are now under extensive...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00003081-197706000-00014

    authors: Fox HE,Hohler CW

    更新日期:1977-06-01 00:00:00

  • Associations Among Lactation, Maternal Carbohydrate Metabolism, and Cardiovascular Health.

    abstract::In mammalian reproductive physiology, lactation follows pregnancy; growing evidence suggests that disruption of this physiology affects a woman's lifetime risk of metabolic disease. These differences may reflect lactation-induced mobilization of fat stores and modulation of maternal stress reactivity. In addition, con...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000155

    authors: Stuebe A

    更新日期:2015-12-01 00:00:00

  • Uterine rupture as a source of obstetrical hemorrhage.

    abstract::Uterine rupture is an important cause of obstetrical hemorrhage associated with morbidity for mother and fetus. Risk factors should be discussed in the counseling process. Intrapartum findings including maternal condition, fetal heart rate monitoring, and uterine activity may prove helpful in making the diagnosis of a...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e3181cc4538

    authors: Lang CT,Landon MB

    更新日期:2010-03-01 00:00:00

  • Reversible antepartum fetal distress.

    abstract::Information generated from the various tests of fetal well-being must be interpreted correctly to avoid unnecessary intervention for assumed fetal distress. This applies to both the intrapartum and antenatal period. The presence of normal data (e.g., reassuring fetal heart rate tracing) allows the woman to continue co...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-198712000-00023

    authors: Nageotte MP

    更新日期:1987-12-01 00:00:00

  • Endometriosis and infertility.

    abstract::Endometriosis is an enigmatic disease affecting up to 10% of reproductive-aged women causing pain and infertility. Up to 50% of women with endometriosis are infertile, and agreement about treatment options has been difficult to establish. The association between endometriosis and infertility is derived from comparison...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0b013e3181db7d71

    authors: Holoch KJ,Lessey BA

    更新日期:2010-06-01 00:00:00

  • Errors and analysis of errors.

    abstract::Methods of analyzing errors and proactively preventing errors are discussed. A framework for using these concepts is presented. ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e3181899a5a

    authors: Mulligan MA,Nechodom P

    更新日期:2008-12-01 00:00:00

  • Tubal surgery.

    abstract::Today, reproductive surgery has a limited place. In selected cases such as young women with a history of pelvic inflammatory disease, pelvic adhesions, and endometriosis, surgery could be considered. Most operations can be performed by laparoscopy; these include tubal anastomosis that yields a high pregnancy rate. On ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e3181b08b5f

    authors: Zarei A,Al-Ghafri W,Tulandi T

    更新日期:2009-09-01 00:00:00

  • Prolonged pregnancy: when should we intervene?

    abstract::The timely onset of labor and birth is an important determinant of perinatal outcome. Prolonged (postterm) pregnancy--defined as delivery at or beyond 42 weeks' gestation--complicates 10% of all gestations and is associated with increased risks to both fetus (stillbirth, macrosomia, birth injury, meconium aspiration s...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e31804c9b11

    authors: Norwitz ER,Snegovskikh VV,Caughey AB

    更新日期:2007-06-01 00:00:00

  • Neonatal abstinence syndrome: treatment and pediatric outcomes.

    abstract::Recent rise in rates of opiate replacement therapy among pregnant women have resulted in increasing number of infants requiring treatment for neonatal abstinence syndrome (NAS). Short-term and long-term developmental outcomes associated with prenatal opiate exposure are discussed, including symptoms and severity of NA...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e31827feea4

    authors: Logan BA,Brown MS,Hayes MJ

    更新日期:2013-03-01 00:00:00

  • Chemotherapy in pregnancy.

    abstract::One in 1000 pregnancies is complicated with cancer with the most common tumors being breast cancer, cervical cancer, thyroid, leukemia, lymphoma, and ovarian cancer. It is often assumed that cancer during pregnancy necessitates sacrificing the well-being of the fetus but in most cases appropriate treatment can be offe...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e318236e9f9

    authors: Brewer M,Kueck A,Runowicz CD

    更新日期:2011-12-01 00:00:00

  • Routine ultrasound in pregnancy.

    abstract::The interest in studying routine ultrasound in pregnancy has provided useful results that can be applied to practice. There is no consistent evidence of risk caused by ultrasound, neither biologic risk for the fetus nor increased use of health services as a result of ascertained conditions. There is also no consistent...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199912000-00003

    authors: Dooley SL

    更新日期:1999-12-01 00:00:00

  • Surgery and Endometriosis.

    abstract::Care of the endometriosis patient today can be complex and difficult. Once medical management has been exhausted and symptoms persist patients desire further treatment options. This chapter takes an evidence-based approach at discussion of patient surgcical options for treatment of endometriosis symptoms. Surgical tec...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0000000000000291

    authors: Zanelotti A,Decherney AH

    更新日期:2017-09-01 00:00:00

  • Treatment of ovarian cancer in young women.

    abstract::Ovarian cancer accounts for approximately 22,000 cases annually in the United States. Although the vast majority of ovarian cancers occur in postmenopausal women and are of advanced stage, a significant subset occurs in young women. Among those subtypes having a predisposition for young women are malignant ovarian ger...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e318248045b

    authors: Gershenson DM

    更新日期:2012-03-01 00:00:00

  • Pruritus in pregnancy.

    abstract::Diagnosis of the cause of pruritus in a pregnant patient should be approached systematically, beginning with a detailed history (especially drug exposure) and physical examination. Systemic diseases must be excluded. Liver function tests and hepatitis screen are in order if symptoms suggest liver dysfunction. Stool ex...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199012000-00007

    authors: Dacus JV

    更新日期:1990-12-01 00:00:00

  • Amniotic and thromboembolism.

    abstract::Embolic phenomena in pregnancy demand rapid investigation and treatment. Regardless, some patients will not survive due to the enormity of the insult. Optimally, such patients should be treated in tertiary care centers, but this is not always possible. ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199009000-00013

    authors: Chatelain SM,Quirk JG Jr

    更新日期:1990-09-01 00:00:00