Pregnancy and adult congenital heart disease.
Increasing numbers of women with complex congenital heart disease are reaching childbearing age. Pregnancy is a major issue in the management of adult congenital heart disease. Cardiac disease is one of the most common causes of maternal morbidity and mortality. Complications, such as growth retardation, preterm and premature birth and even fetal and neonatal mortality, are more frequent among children of women with congenital heart disease. The risk of complications is determined by the severity of the cardiac lesion, the presence of cyanosis, the maternal functional class and the use of anticoagulation. However, the pathophysiology of these complications is not completely understood and may be related to a diminished increase in cardiac output and/or endothelial dysfunction. The management of pregnant cardiac patients is based on limited clinical information. This article reviews pre-pregnancy counseling and management during pregnancy in patients with congenital heart disease.
Karamermer
Yusuf
Y
Erasmus MC, Department of Cardiology, Room Ba308, s-Gravendijkwal 230, PO Box 2040, 3000 CA Rotterdam, The Netherlands. yusufkaramermer@hotmail.com
Roos-Hesselink
Jolien W
JW
D000328:Adult; D001794:Blood Pressure; D002302:Cardiac Output; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D006339:Heart Rate; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology / Q000628:therapy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D047928:Premature Birth; D012720:Severity of Illness Index; D014655:Vascular Resistance; D016277:Ventricular Function, Left