title: Management of pregnancy in patients with congenital heart disease.
abstract: Congenital heart diseases are the most common birth defects in humans, affecting approximately 0.8% of all live births. In the past, many of the more severe defects resulted in profound disability and death during childhood, and adult survival was exceptional. The past 4 decades have seen dramatic improvements in the survival and quality of life of patients with the more severe defects. As a result of these improvements, the challenges of caring for adults with congenital heart disease are only now being realized. Most women with congenital heart disease are now expected to reach childbearing age and maternal cardiac disease is the major cause of maternal morbidity and mortality. As such, appropriate pre-pregnancy counseling and management during pregnancy are fundamental components of the care of these patients. This article describes the circulatory changes that occur during normal pregnancy and delivery, addresses the risks posed during pregnancy by specific congenital lesions, and reviews the current data on pregnancy outcomes in patients with individual congenital defects.
authors.affiliation: Division of Cardiology, Department of Medicine, University of California, San Francisco, CA 94143-0214, USA. harrisi@medicine.ucsf.edu
authors.forename: Ian S
authors.initials: IS
authors.lastname: Harris
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001810:Blood Volume; D002302:Cardiac Output; D003376:Counseling; D005260:Female; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006343:Heart Septal Defects / Q000628:therapy; D006349:Heart Valve Diseases / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology; D055947:Loeys-Dietz Syndrome / Q000628:therapy; D008382:Marfan Syndrome / Q000150:complications / Q000628:therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000502:physiology; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000502:physiology; D017741:Survivors; D016216:Ultrasonography, Prenatal; D014655:Vascular Resistance