Cardiac disease and pregnancy.
The pregnant state imposes a supraphysiologic strain on the pregnant woman's cardiac performance through complex biochemical, electric, and physiologic changes affecting the blood volume, myocardial contractility, and resistance of the vascular bed. In the presence of underlying heart disease, these changes can compromise the woman's hemodynamic balance, her life, and that of her unborn child. Cardiac pathology represents a heterogeneous group of disorders, each with its own hemodynamic, genetic, obstetric, and social implications. Physicians caring for these women should actively address the issue of reproduction. Ideally, pregnancy should be planned to occur after optimization of cardiac performance by medical or surgical means. Once pregnancy is achieved, the concerted effort of a multidisciplinary team of obstetricians, cardiologists, anesthesiologists, nursing, social, and other services provides the best opportunity to carry the pregnancy to a successful outcome.
Gei
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AF
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Texas Medical Branch at Galveston, Galveston, Texas, USA. afgei@utmb.edu
Hankins
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GD
D000465:Algorithms; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002320:Cardiovascular Physiological Phenomena; D036861:Delivery, Obstetric; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011181:Postnatal Care; D016742:Preconception Care; D011247:Pregnancy / Q000502:physiology; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D011295:Prenatal Care; D012306:Risk
D002317:Cardiovascular Agents