Role of Echocardiography in Assessing Pregnant Women With and Without Heart Disease

Kamiya, Chizuko; Nakatani, Satoshi; Hashimoto, Shuji; Masuda, Yoshikazu; Neki, Reiko; Ikeda, Tomoaki

doi:10.2303/jecho.6.29

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Assessment of pregnancy risk should include detailed cardiac, surgical and obstetric history, physical examination, documentation of oxygen saturations, 12-lead ECG and transthoracic echocardiography. 11) Maternal functional status is an important determinant of outcome and should be documented. Exercise stress testing provides an objective measure of functional capacity and can assess blood pressure response to exercise in women with aortic stenosis (AS).…”

Section: Cardiac Assessment Before Pregnancymentioning

confidence: 99%

“…Echocardiography, a noninvasive method providing detailed information, is very useful in evaluating hemodynamics during pregnancy. 11) The first assessment should be conducted before pregnancy or during the first trimester when changes in hemodynamics are still slight. But pregnant women are often visiting outpatient clinic of cardiologists after becoming pregnant (5–8 weeks of gestation), so initial echo data will be obtained at that time.…”

Section: Hemodynamic Assessment and Cardiac Investigations During Prementioning

confidence: 99%

“…Patients with mild to moderate risk category should be evaluated for hemodynamics again during the late second trimester (26–28 weeks of gestation). 11) Women with severe risk require more frequent hemodynamics assessment. When necessary, transoesophageal echocardiography is useful and also safe in pregnancy.…”

Section: Hemodynamic Assessment and Cardiac Investigations During Prementioning

confidence: 99%

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Adult Congenital Heart Disease with Pregnancy

Niwa

2018

Korean Circ J

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The number of women with congenital heart disease (CHD) at risk of pregnancy is growing because over 90% of them are grown-up into adulthood. The outcome of pregnancy and delivery is favorable in most of them provided that functional class and systemic ventricular function are good. Women with CHD such as pulmonary hypertension (Eisenmenger syndrome), severe left ventricular outflow stenosis, cyanotic CHD, aortopathy, Fontan procedure and systemic right ventricle (complete transposition of the great arteries [TGA] after atrial switch, congenitally corrected TGA) carry a high-risk. Most frequent complications during pregnancy and delivery are heart failure, arrhythmias, bleeding or thrombosis, and rarely maternal death. Complications of fetus are prematurity, low birth weight, abortion, and stillbirth. Risk stratification of pregnancy and delivery relates to functional status of the patient and is lesion specific. Medication during pregnancy and post-delivery (breast feeding) is a big concern. Especially prescribing medication with teratogenicity should be avoidable. Adequate care during pregnancy, delivery, and the postpartum period requires a multidisciplinary team approach with cardiologists, obstetricians, anesthesiologists, neonatologists, nurses and other related disciplines. Caring for a baby is an important issue due to temporarily pregnancy-induced cardiac dysfunction, and therefore familial support is mandatory especially during peripartum and after delivery. Timely pre-pregnancy counseling should be offered to all women with CHD to prevent avoidable pregnancy-related risks. Successful pregnancy is feasible for most women with CHD at relatively low risk when appropriate counseling and optimal care are provided.

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Section: Cardiac Assessment Before Pregnancymentioning

confidence: 99%

Section: Hemodynamic Assessment and Cardiac Investigations During Prementioning

confidence: 99%

Section: Hemodynamic Assessment and Cardiac Investigations During Prementioning

confidence: 99%

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Adult Congenital Heart Disease with Pregnancy

Niwa

2018

Korean Circ J

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“…Echocardiography, a noninvasive method providing detailed information, is very useful in evaluating hemodynamics during pregnancy. 25 The first assessment should be conducted immediately before pregnancy or during the first trimester when changes in hemodynamics are still slight.…”

Section: Hemodynamic Assessment During Pregnancymentioning

confidence: 99%

Guidelines for Indication and Management of Pregnancy and Delivery in Women With Heart Disease (JCS 2010) - Digest Version -

Group¹

2012

Circ J

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“…Echocardiography can assess the hemodynamic changes noninvasively; thus, it is widely used to measure cardiocirculatory indices during pregnancy and after delivery. 5 Regarding the changes in echocardiographic parameters, left ventricular (LV) end-diastolic and end-systolic dimensions and wall thickness increase, and contractile function enhances. Functional pulmonary, tricuspid, and mitral regurgitation and mild pericardial effusion are occasionally seen in normal pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Structural and Functional Changes in Maternal Heart during Pregnancy: An Echocardiographic Study

et al. 2017

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Background Pregnancy is associated with profound physiologic alterations in the maternal cardiovascular system. This study aimed to investigate maternal cardiac performance during normal pregnancy by two-dimensional echocardiography parameters and various functional and structural alterations. Methods This was a cross-sectional study of 100 normal pregnant women who attended the antenatal clinic, and all participants had clinical history, physical examination, and 12-lead electrocardiogram. Two-dimensional, M-mode, and Doppler echocardiography was done. Echocardiographic parameters were compared with normal age-matched controls from previously published studies. Results The mean age of the study group was 23.35 ± 3.05 years, mean systolic blood pressure was 110.5 ± 8.69 mm Hg, and mean diastolic blood pressure was 71.6 ± 6.77 mm Hg. There was an increase in left atrial (LA) diameter, left ventricular end diastolic diameter, and interventricular septum (IVS) thickness as gestational age advanced. There was a gradual decrease in E-wave velocity, and E/A ratio increased during the second trimester and decreased during the third trimester. The E-wave deceleration time increased with gestational age There was no statistically significant difference between IVS thickness and E/A ratio (p = 1.000). Conclusion Cardiac chamber dimensions, LV wall thickness, and LA size, most indices of systolic function although within normal range, were significantly higher in pregnant Asian Indian women than in the controls. This study shows that the subtle reduction in myocardial compliance appears as an adaptive response to changes of preload, afterload, and LV geometry.

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Role of Echocardiography in Assessing Pregnant Women With and Without Heart Disease

Cited by 5 publications

References 27 publications

Adult Congenital Heart Disease with Pregnancy

Adult Congenital Heart Disease with Pregnancy

Guidelines for Indication and Management of Pregnancy and Delivery in Women With Heart Disease (JCS 2010) - Digest Version -

Structural and Functional Changes in Maternal Heart during Pregnancy: An Echocardiographic Study

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