title: Maternal cardiac disease: update for the clinician.
abstract: Heart disease complicates more than 1% of pregnancies and is now the leading cause of indirect maternal deaths. The spectrum and severity of heart disease observed in reproductive-aged women is changing. Today, congenital heart disease accounts for more than half of cardiac disease in pregnancy, and ischemic heart disease is on the rise as a result of obesity, hypertension, diabetes, and delayed childbearing. Pregnancy is still contraindicated in women with pulmonary hypertension, severe systemic ventricular dysfunction, dilated aortopathy, and severe left-sided obstructive lesions, but advances in medical and surgical management have resulted in an increasing number of patients with congenital heart defects reaching childbearing age who are interested in pregnancy. A multidisciplinary approach can best determine whether acceptable outcomes can be expected and what management strategies may improve the prognosis for pregnant women with heart disease.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York, USA. ls731@columbia.edu
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Simpson
mesh_terms: D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000628:therapy*; D006331:Heart Diseases / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000628:therapy; D010348:Patient Care Team; D016742:Preconception Care; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology / Q000628:therapy*; D011295:Prenatal Care