Heart Disease in Pregnancy

Swiet, Michael de

doi:10.1002/9780470752371.ch5

Cited by 5 publications

(6 citation statements)

References 286 publications

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“…In addition, rheumatic heart disease is still prevalent in many of these countries where it remains the main cause of cardiovascular morbidity and mortality. This is in contrast to developed countries where the ratio of rheumatic heart disease to congenital heart disease has decreased due to the dramatic decline in the incidence of rheumatic fever (although there may have been a resurgence recently) and to significant advances in the management of congenital heart disease 4,13,14 . In fact, young immigrants probably constitute most if not all of the rheumatic heart disease in pregnancy seen in the UK, as suggested by our study.…”

Section: Discussioncontrasting

confidence: 63%

Prevalence of heart disease diagnosed de novo in pregnancy in a West London population

Tan

Swiet

1998

BJOG

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Objectives To determine the prevalence of heart disease diagnosed de novo in pregnancy in a West London population and to re‐examine the current role of routine cardiovascular examination in antenatal care in the UK. Design Retrospective study. Setting Obstetric medical clinics at Queen Charlotte's and Chelsea Hospital, University College Hospital and Northwick Park Hospital. Population Three hundred and twenty women referred for cardiac evaluation during pregnancy. Results The majority of the 139 women referred specifically for evaluation of murmurs during pregnancy were found to have physiological murmurs (97%). Only four women (3%) were found to have significant cardiac lesions de novo in their pregnancy. Three of these four women were immigrants who had no previous history of heart disease. The only woman from the UK was already known to have a murmur from childhood. Conclusions Our study shows that heart disease diagnosed de novo in pregnancy in a West London population is an uncommon problem with low prevalence. It also appears to be a problem seen mainly in the immigrant population. The results emphasise the importance of taking a thorough medical history in all pregnant women. However, our results if they are confirmed, would suggest that only immigrants and those with significant symptoms or a known history of heart murmur or heart disease need undergo cardiovascular examination during pregnancy. These findings need to be confirmed in a larger group in other parts of the UK before further recommendations on selective cardiovascular examination can be made. This will have significant implications for midwifery‐led care.

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Section: Discussioncontrasting

confidence: 63%

Prevalence of heart disease diagnosed de novo in pregnancy in a West London population

Tan

Swiet

1998

BJOG

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“…In addition, a detailed fetal scan to exclude fetal cardiac anomaly is necessary due to the increased risk of cardiac anomalies in infants born to mothers with CHD. [ 3 4 ] Most complications arise from the increase in right to left shunting during pregnancy resulting in further hypoxemia and acidosis. There is a direct relationship between chronic hypoxemia, polycythemia, uteroplacental insufficiency, and pregnancy outcome.…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 10 ] Induction near term may be justified to plan delivery in complicated cases requiring optimal medical support. [ 3 ] Although intravenous analgesics provide satisfactory pain relief for some women, continuous epidural analgesia is recommended in most cases. [ 6 ] Care must be taken to achieve meticulous haemostasis, maintain good hydration, and to avoid vasodilation (for example, with high dose epidural) and air emboli through venous lines.…”

Section: Discussionmentioning

confidence: 99%

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Successful pregnancy in a patient with univentricular heart and pulmonary stenosis

Nilofer

Zaki

2012

Heart Views

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“…A rare idiopathic disease having an incidence of 1 in 4,000 in the obstetric population, presenting with signs and symptoms of heart failure, with significant morbidity and mortality (35–50%) goes by the moniker of “peripartum cardiomyopathy” (PPCM). [ 1 2 3 4 ] Whilst there has been a multitude of case reports enunciating anaesthetic challenges in this population, we present a case which was distinct for the concomitant presence of preeclampsia and florid heart failure on the operating room (OR) table. [ 5 6 7 ]…”

Section: Introductionmentioning

confidence: 99%

An anaesthetic quandary

Sahu

Swain

Singh

et al. 2021

Journal of Family Medicine and Primary Care

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Anaesthetic management of cardiac disorders in pregnancy has always been complicated and challenging. A rare but extremely fatal entity, peripartum cardiomyopathy (PPCM) is a life-threatening disease affecting the parturient with mortality rates as high as 35–50%. Developing in late pregnancy or immediately after delivery, this unique disorder endangers not only the mother but the baby as well. We report here a case of a 28-year-old female parturient presenting at 37 weeks of gestation for caesarean delivery with recently diagnosed peripartum cardiomyopathy (ejection fraction of 28%) complicated by severe preeclampsia. She developed cardiac failure just before the induction of anaesthesia. She was successfully resuscitated, operated under general anaesthesia and shifted to the critical care unit for further management.

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Heart Disease in Pregnancy

Cited by 5 publications

References 286 publications

Prevalence of heart disease diagnosed de novo in pregnancy in a West London population

Prevalence of heart disease diagnosed de novo in pregnancy in a West London population

Successful pregnancy in a patient with univentricular heart and pulmonary stenosis

An anaesthetic quandary

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