Cardiovascular Medications in Pregnancy: A Primer

Area of Science:

• Obstetrics and Cardiology
• Maternal-Fetal Medicine
• Pharmacology

Background:

• Cardiovascular disease (CVD) is a primary cause of maternal morbidity and mortality in the US.
• Increased rates of obesity, delayed childbearing, and advanced medical technology lead to more pregnancies with pre-existing comorbidities.
• The use of cardiovascular medications during pregnancy is rising, necessitating specialized medical management.

Purpose of the Study:

• To highlight the increasing prevalence of cardiovascular conditions in pregnancy.
• To emphasize the need for obstetricians and cardiologists to understand cardiovascular medication use in pregnant patients.
• To review the pharmacokinetics of common cardiovascular drugs in the context of pregnancy, embryogenesis, and lactation.

Main Methods:

• Literature review of cardiovascular medication use in pregnancy.
• Analysis of physiological changes during pregnancy affecting drug pharmacokinetics.
• Examination of drug effects on embryogenesis and lactation.

Main Results:

• Pregnancy significantly alters drug pharmacokinetics, impacting medication efficacy and safety.
• Specific cardiovascular medications require careful consideration due to potential effects on fetal development and breastfeeding.
• Physiological adaptations during pregnancy necessitate individualized dosing and monitoring of cardiovascular therapies.

Conclusions:

• Obstetric and cardiology providers must be knowledgeable about cardiovascular drug pharmacokinetics in pregnancy.
• Effective management requires understanding how pregnancy-related physiological changes influence cardiovascular medications.
• This knowledge is crucial for ensuring the safety and well-being of both mother and child.