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[Cardiovascular diseases during pregnancy and delivery]
Zoran Stajić1, Zdravko Mijailović2, Mirjana Bogavac3
1Vojnomedicinska akadmija, Beograd Klinika za kardiologiju. zoran0312@yahoo.com
Insights
Cardiovascular diseases are a leading cause of maternal death. Early recognition and specialized care are crucial for pregnant women with heart conditions to prevent mortality.
Area of Science:
- Obstetrics and Gynecology
- Cardiology
- Maternal Health
Context:
- Cardiovascular diseases (CVDs) are the primary cause of maternal morbidity and mortality.
- Pregnancy induces physiological cardiovascular changes (increased blood volume, decreased vascular resistance) that can worsen pre-existing or acquired CVDs.
- Pregnant women with CVDs face risks like tachycardia, palpitations, and edema, necessitating careful management.
Purpose:
- To highlight the significance of cardiovascular diseases in pregnancy.
- To outline physiological adaptations during pregnancy that impact cardiovascular status.
- To identify common congenital and acquired cardiovascular conditions in pregnant individuals.
Summary:
- Physiological cardiovascular adaptations during pregnancy can exacerbate existing heart conditions.
- Common congenital heart defects include septal defects and patent ductus arteriosus; acquired conditions include arrhythmias, hypertension, and valvular diseases.
- Key predictors of maternal mortality in pregnant women with CVDs include pulmonary hypertension, valvular lesion significance, cyanosis, and heart failure status.
Impact:
- Early recognition and diagnosis of CVDs in pregnancy are vital for reducing maternal mortality.
- Referral to tertiary centers with multidisciplinary teams experienced in high-risk pregnancies ensures optimal care.
- A proactive approach to managing cardiovascular health in pregnancy is essential for positive maternal and fetal outcomes.
Introduction:
Nowadays, cardiovascular diseases are the leading cause of maternal morbidity and mortality in the current obstetric practice. PHYSIOLOGICALLY ADAPTED MECHANISMS OF THE CARDIOVASCULAR SYSTEM IN PREGNANCY: It is normal that during pregnancy some physiological adaptive changes of the cardiovascular system occur and they may contribute to the deterioration of the clinical cardiac status of a patient with preexisting or acquired cardiovascular disease. The most prominent adaptive mechanisms include the increase of circulating blood volume, decrease of peripheral vascular resistance and decrease of plasma colloid-oncotic pressure. MOST FREQUENT DISEASES OF THE CARDIOVASCULAR SYSTEM IN PREGNANCY: Due to these changes, pregnant women are prone to tachycardia, palpitations and peripheral edema. Maternal counseling is obligatory for each pregnant woman in order to decrease the maternal morbidity and mortality. The most important predictors of maternal mortality for pregnant women with cardiovascular diseases are severity of pulmonary hypertension, hemodynamic significance of valvular lesion, cyanosis and functional status in heart failure. Cardiovascular diseases in pregnant women may be congenital or acquired. The most frequent congenital cardiac diseases are atrial and ventricular septal defects as well as persistent ductus arteriosus. These diseases are mainly diagnosed and corrected before the pregnancy, or left untreated if hemodynamically insignificant. The most frequent acquired cardiovascular diseases during pregnancy include arrhythmias, ischemic heart disease, rheumatic mitral stenosis and insufficiency, arterial hypertension and aortic dissection.
Conclusion:
In all cases of pregnancy associated with cardiovascular diseases, early recognition of cardiovascular disease is crucial, as well as correct diagnosis and referral to a tertiary centre equipped for a multidisciplinary approach of specialists experienced in high-risk pregnancies and deliveries in order to prevent maternal mortality.
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