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Evaluation and Management of Maternal Congenital Heart Disease: A Review

Maeve K Hopkins1, Sarah A Goldstein2, Cary C Ward3

  • 1Resident, Department of Obstetrics and Gynecology.

Obstetrical & Gynecological Survey
|February 27, 2018
PubMed

Insights

Women with congenital heart disease (CHD) can often have successful pregnancies with appropriate care. Understanding cardiac physiology and coordinating specialists are key for managing CHD during pregnancy.

Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Obstetrics

Background:

  • Congenital heart defects (CHD) are the most common major congenital anomalies.
  • Advances in treatment allow more women with CHD to reach childbearing age.

Purpose of the Study:

  • Define common forms of CHD in pregnancy.
  • Outline preconception counseling.
  • Review management recommendations for CHD in pregnancy.

Main Methods:

  • MEDLINE search conducted for "congenital heart disease in pregnancy" and specific conditions.
  • Included terms: ventricular septal defect, atrial septal defect, outflow obstructions, tetralogy of Fallot, transposition of the great vessels.

Main Results:

  • Review incorporated 18 retrospective studies, 8 meta-analyses/systematic reviews/expert opinions, 5 case reports, 2 prospective studies, and 2 clinical texts.
  • Identified specific CHD conditions with significant maternal risks, where pregnancy may be contraindicated.

Conclusions:

  • Many women with CHD can achieve successful pregnancies.
  • Requires understanding of pregnancy-related cardiac physiology.
  • Emphasizes coordinated care between cardiology and maternal-fetal medicine specialists.
Abstract

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