Addressing maternal mortality: the pregnant cardiac patient

Wolfe, Diana; Hameed, Afshan B.; Taub, Cynthia C.; Zaidi, Ali N.; Bortnick, Anna E.

doi:10.1016/j.ajog.2018.09.035

Cited by 47 publications

(27 citation statements)

References 23 publications

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“…In previous studies, retrospective investigations of cardiovascular maternal mortality in pregnancy were, due to a missed diagnosis of a cardiovascular condition or new-onset cardiovascular disease as a common theme [26]. Wolfe et al [27] stressed the importance of early cardiovascular screening for symptoms of CVD and improved management of hypertension as imperative to prevent maternal deaths. Barriers to pre-pregnancy assessment missed opportunities to identify cardiac risk factors during prenatal care, gaps in high-risk intrapartum care and delayed recognition of cardiovascular symptoms were contributory factors [27].…”

Section: Plos Onementioning

confidence: 99%

“…Wolfe et al [27] stressed the importance of early cardiovascular screening for symptoms of CVD and improved management of hypertension as imperative to prevent maternal deaths. Barriers to pre-pregnancy assessment missed opportunities to identify cardiac risk factors during prenatal care, gaps in high-risk intrapartum care and delayed recognition of cardiovascular symptoms were contributory factors [27]. A notable incident in this study occurred when a pregnant primigravida woman attended the women's assessment clinic for blood pressure monitoring.…”

Section: Plos Onementioning

confidence: 99%

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Adherence to clinical practice guidelines for South Australian pregnant women with cardiac conditions between 2003 and 2013

et al. 2020

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Background For pregnant women with a known cardiac condition or those who develop cardiac disease during pregnancy, there is an increased risk of complications during pregnancy, to both mother and foetus. To reduce this risk, best practice guidelines have been developed and available in South Australia for several years. Measuring clinical practice against the guideline recommendations verifies real-life practice and an essential part of any clinical practice quality improvement project by identifying gaps. This study is the first report on adherence to statewide perinatal guidelines for these women in South Australia.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Adherence to clinical practice guidelines for South Australian pregnant women with cardiac conditions between 2003 and 2013

et al. 2020

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“…The team approach was central to the management of this case so that all specialists involved understood the patient's physiology and peripartum risk for heart failure. 5 This patient had a large PDA with low-normal LVEF along with severely dilated LA and LV, which placed her at high risk for peripartum decompensation. Ideally, her PDA should have been closed prior to attempted pregnancy.…”

Section: Discussionmentioning

confidence: 95%

Patent Ductus Arteriosus in Pregnancy: Cardio-Obstetrics Management in a Late Presentation

Zhang

Wengrofsky

Wolfe

et al. 2021

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“…In labor, an early epidural is recommended in order to minimize further catecholaminergic stimulus secondary to pain [14]. It is recommended that a multidisciplinary team comprising a labor and delivery nurse, cardiac nurse, anesthesiology, obstetrician, and cardiologist with knowledge of tachyarrhythmias be readily available [15]. Intrapartum continuous cardiac monitoring should be considered [10].…”

Section: Discussionmentioning

confidence: 99%

Catecholaminergic polymorphic ventricular tachycardia in pregnancy: a case report

Schumer

Contag

2020

J Med Case Reports

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Introduction Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a genetic disorder that can cause fatal tachyarrhythmias brought on by physical or emotional stress. There is little reported in the literature regarding management of CPVT in pregnancy much less during labor. Case presentation A gravida 2, para 1 presented to our high-risk clinic at 15 weeks gestation with known CPVT. The Caucasian female patient had been diagnosed after experiencing a cardiac arrest following a motor vehicle accident and found to have a pathogenic cardiac ryanodine receptor mutation. An implantable cardioverter defibrillator was placed at that time. Her pregnancy was uncomplicated, and she was medically managed with metoprolol, flecainide, and verapamil. Her labor course and successful vaginal delivery were uncomplicated and involved a multidisciplinary team comprising specialists in electrophysiology, maternal fetal medicine, anesthesiology, general obstetrics, lactation, and neonatology. Conclusions CPVT is likely underdiagnosed and, given that cardiovascular disease is a leading cause of death in pregnancy, it is important to bring further awareness to the diagnosis and management of this inherited arrhythmia syndrome in pregnancy.

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Addressing maternal mortality: the pregnant cardiac patient

Cited by 47 publications

References 23 publications

Adherence to clinical practice guidelines for South Australian pregnant women with cardiac conditions between 2003 and 2013

Adherence to clinical practice guidelines for South Australian pregnant women with cardiac conditions between 2003 and 2013

Patent Ductus Arteriosus in Pregnancy: Cardio-Obstetrics Management in a Late Presentation

Catecholaminergic polymorphic ventricular tachycardia in pregnancy: a case report

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