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Cardiac pregnancy

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https://www.readbyqxmd.com/read/28719470/diurnal-variation-and-repeatability-of-arterial-stiffness-and-cardiac-output-measurements-in-the-third-trimester-of-uncomplicated-pregnancy
#1
Mohamed W Osman, Francesca Leone, Mintu Nath, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa
AIM: To investigate same day repeated measures and diurnal variation of arterial stiffness, cardiac output (CO), stroke volume (SV) and total peripheral resistance (TPR) during the third trimester of normal pregnancy. METHODOLOGY: Pulse wave velocity (PWV) and augmentation index (AIx) were recorded using the Arteriograph, while CO, SV and TPR were recorded using noninvasive cardiac output monitoring. The measurements were obtained in the third trimester of pregnancy from 21 healthy pregnant women at four time points (morning, afternoon, evening and midnight) over a 24-h period...
July 14, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#2
Philippe Biderman, Uri Carmi, Eric Setton, Michael Fainblut, Oren Bachar, Sharon Einav
The American Heart Association scientific statement on cardiac arrest in pregnancy did not endorse extracorporeal life support for lack of cohort data. We studied all pregnancy and peripartum cases of extracorporeal life support in 1 medical center (n = 11), including collapse due to infection (n = 6, 55%), thromboembolism (n = 3, 27%), and cardiac disease (n = 2, 18%). Half of the cases (n = 5, 45%) involved extracorporeal cardiopulmonary resuscitation. Most mothers survived (n = 7, 64% [95% confidence interval, 32%-88%])...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28715153/automated-analysis-of-fetal-cardiac-function-using-color-tissue-doppler-imaging
#3
L Herling, J Johnson, K Ferm-Widlund, F Bergholm, P Lindgren, S-E Sonesson, G Acharya, M Westgren
OBJECTIVES: Our main objective was to evaluate the feasibility of an automated analysis of fetal myocardial velocity recordings obtained by color tissue Doppler imaging (cTDI). METHODS: This was a prospective cross-sectional observational study of 107 singleton pregnancies in ≥41 weeks of gestation. Myocardial velocity recordings were obtained by cTDI in a long-axis four-chamber view of the fetal heart. Regions of interest (ROI) were placed in the septum, right (RV) and left ventricular (LV) walls at the level of the atrioventricular plane (AV-plane)...
July 17, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28714608/selective-serotonin-reuptake-inhibitors-during-pregnancy-do-we-have-now-more-definite-answers-related-to-prenatal-exposure
#4
REVIEW
Asher Ornoy, Gideon Koren
Despite extensive studies, there still seems to be uncertainty as to the possible reproductive risk of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SNRIs) in pregnancy. We, therefore, assess the current data on the risk/benefit of SSRI use in pregnancy. As the neurodevelopmental effects of SSRIs are discussed in another paper in this issue, we will not address the possible neurodevelopmental effects. Special emphasis is given to the newer, large population-based studies...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28714604/antidepressants-antipsychotics-and-mood-stabilizers-in-pregnancy-what-do-we-know-and-how-should-we-treat-pregnant-women-with-depression
#5
REVIEW
Asher Ornoy, Liza Weinstein-Fudim, Zivanit Ergaz
Depression is generally treated with antidepressants, but may often need antipsychotics and mood stabilizers. We discuss the updated data regarding the safety in pregnancy of antidepressants and antipsychotics, except selective serotonin reuptake inhibitors, and their possible impact on the long-term development of the offspring. Several earlier studies demonstrated a slight increase in the rate of major anomalies following maternal tricyclic antidepressant treatment, but most current literature shows their relative safety in pregnancy...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28713431/an-unexpected-cause-of-bradycardia-in-a-patient-with-bacterial-meningitis
#6
Petros Ioannou, Magdalini Velegraki, Stella Soundoulounaki, Achilleas Gikas, Diamantis P Kofteridis
Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28707745/survival-of-the-fetus-during-maternal-thoracotomy-under-cardiopulmonary-bypass-for-infective-endocarditis
#7
Li Luo, Qiulei Sun, Liping Chen, Demei Ying, Xiaohua Wu, Zhengqiong Chen
Infective endocarditis (IE) during pregnancy is a rare but serious condition. Cardiopulmonary bypass during pregnancy has a high rate of fetal morbidity and mortality. We here report the case of a 22-year-old pregnant woman with confirmed IE. Multiple large cardiac valve vegetations, severe aortic valve regurgitation, and hemodynamic compromise were observed. With full implementation of fetal monitoring and protection strategies, open heart surgery was performed at 31.4 weeks' gestation to aid survival, followed by an elective cesarean delivery at 34...
July 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28706585/atrial-tachyarrhythmia-in-adult-congenital-heart-disease
#8
REVIEW
Arsha Karbassi, Krishnakumar Nair, Louise Harris, Rachel M Wald, S Lucy Roche
The adult congenital heart disease (ACHD) population continues to grow and most cardiologists, emergency room physicians and family doctors will intermittently come into contact with these patients. Oftentimes this may be in the setting of a presentation with atrial tachyarrhythmia; one of the commonest late complications of ACHD and problem with potentially serious implications. Providing appropriate initial care and ongoing management of atrial tachyarrhythmia in ACHD patients requires a degree of specialist knowledge and an awareness of certain key issues...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28696953/out-of-air-is-going-to-high-altitude-safe-for-your-patient
#9
Ann M Mendenhall, Christopher P Forest
As more people travel to high altitudes for recreation or work, more travelers with underlying medical conditions will need advice before traveling or treatment for altitude illness. This article focuses on the two main issues for travelers: whether travel to a high altitude will have a negative effect on their underlying medical condition and whether the medical condition increases the patient's risk of developing altitude illness. Although patients with severe pulmonary or cardiac conditions are most at risk in the hypoxic environment, other conditions such as diabetes and pregnancy warrant attention as well...
July 10, 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28695721/aortic-isthmus-shunt-dynamics-in-normal-and-complicated-monochorionic-pregnancies
#10
Viola Seravalli, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat, Jena Miller
OBJECTIVE: To study fetal aortic isthmus (AoI) shunt dynamics in monochorionic (MC) twins. METHODS: Normal and complicated MC pregnancies were prospectively enrolled. The relationship of isthmus flow index (IFI) with Doppler parameters of umbilical artery (UA), descending aorta (DAo), middle cerebral artery (MCA), and ductus venosus (DV), and with left and right ventricular cardiac output and stroke volume was studied. RESULTS: The IFI was obtained in 180 examinations from 48 pregnancies (24 twin-twin-transfusion syndrome, TTTS; 4 selective intrauterine growth restriction, sIUGR; 12 TTTS+sIUGR; 8 uncomplicated)...
July 11, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28694782/evaluation-of-abdominal-fetal-electrocardiography-in-early-intrauterine-growth-restriction
#11
Clarissa L Velayo, Kiyoe Funamoto, Joyceline Noemi I Silao, Yoshitaka Kimura, Kypros Nicolaides
Objectives: This descriptive study was performed to evaluate the capability of a non-invasive transabdominal electrocardiographic system to extract clear fetal electrocardiographic (FECG) measurements from intrauterine growth restricted (IUGR) fetuses and to assess whether abdominal FECG parameters can be developed as markers for evaluating the fetal cardiac status in IUGR. Methods: Transabdominal FECG was attempted in 20 controls and 15 IUGR singleton pregnancies at 20+0-33+6 weeks gestation. Standard ECG parameters were compared between the study groups and evaluated for their correlation...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28694109/mathematical-modelling-of-the-maternal-cardiovascular-system-in-the-three-stages-of-pregnancy
#12
Chiara Corsini, Elena Cervi, Francesco Migliavacca, Silvia Schievano, Tain-Yen Hsia, Giancarlo Pennati
In this study, a mathematical model of the female circulation during pregnancy is presented in order to investigate the hemodynamic response to the cardiovascular changes associated with each trimester of pregnancy. First, a preliminary lumped parameter model of the circulation of a non-pregnant female was developed, including the heart, the systemic circulation with a specific block for the uterine district and the pulmonary circulation. The model was first tested at rest; then heart rate and vascular resistances were individually varied to verify the correct response to parameter alterations characterising pregnancy...
July 7, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28682423/assessments-of-m-mode-color-echocardiography-on-fetal-right-ventricular-diastolic-function-with-umbilical-cord-around-neck
#13
W Shi, H-X Liu, Z-D Xuan, L Zhao, J-Z Li, Y-H Wang
OBJECTIVE: To investigate the fetal right ventricular diastolic function under the condition of umbilical cord around neck (UCAN), and analyze the changes of the right ventricular propagation velocity (Vp), then discuss the clinical value of the color M-mode echocardiography in the evaluation of fetal ventricular diastolic function quantitatively. PATIENTS AND METHODS: All patients enrolled were with singleton pregnancy from Cangzhou Central Hospital from December 2013 to December 2015 as the experimental group...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28681937/maternal-nicotine-exposure-leads-to-decreased-cardiac-protein-disulfide-isomerase-and-impaired-mitochondrial-function-in-male-rat-offspring
#14
Nicole G Barra, Maria Lisyansky, Taylor A Vanduzer, Sandeep Raha, Alison C Holloway, Daniel B Hardy
Smoking throughout pregnancy can lead to complications during gestation, parturition and neonatal development. Thus, nicotine replacement therapies are a popular alternative thought to be safer than cigarettes. However, recent studies in rodents suggest that fetal and neonatal nicotine exposure alone results in cardiac dysfunction and high blood pressure. While it is well known that perinatal nicotine exposure causes increased congenital abnormalities, the mechanisms underlying longer-term deficits in cardiac function are not completely understood...
July 6, 2017: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/28681178/heart-disease-and-pregnancy
#15
REVIEW
Reza Ashrafi, Stephanie L Curtis
Cardiac disease remains a major cause of morbidity and mortality in pregnant and post-partum women, although progress has been made, with specialist joint obstetric-cardiology clinics providing an integrated, safe and personalised service to these women. As a result, fewer non-specialist cardiologists are managing women in pregnancy with cardiovascular disease. The aim of this review is to provide a brief overview of current knowledge and practice in the field, with an emphasis on the major physiological changes which occur during pregnancy, focussing on progress through the trimesters, clinical assessment in pregnancy, management of delivery (concentrating on managed vaginal delivery), drug treatment, key conditions and risk assessment...
July 5, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28680470/a-case-of-successfully-managed-pregnancy-in-a-patient-with-complex-cyanotic-congenital-heart-disease
#16
J Y Liu, W K Tan, E L Tan, J L Tan, L K Tan
Medical advances have increased survival of patients with congenital heart disease. However, cardiac disease in pregnancy carries significant maternal and fetal risks, posing enormous challenges to obstetricians. Cyanotic congenital heart disease is associated with maternal complications such as arrhythmias, thromboembolic events and death. Fetal complications include small for gestational age, miscarriage and prematurity. Cyanotic congenital heart disease patients who continue their pregnancies require holistic multidisciplinary team care with early and coordinated planning for delivery...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28680462/congenital-heart-disease-and-pregnancy-a-contemporary-approach-to-counselling-pre-pregnancy-investigations-and-the-impact-of-pregnancy-on-heart-function
#17
REVIEW
Matthew Cauldwell, Michael Gatzoulis, Philip Steer
Cardiac disease in pregnancy is a challenging clinical problem. The number of women pursuing pregnancy and the underlying complexity of their cardiac disease is increasing, such that heart disease is now the leading cause of maternal mortality in developed countries. Women with congenital heart disease make up the majority of these cases and although maternal mortality is infrequent, a good outcome is only achieved though meticulous multidisciplinary care, beginning with pre-pregnancy counselling. All women with congenital heart disease should be assessed and be referred for pre-conception counselling prior to pregnancy and should receive thorough clinical assessment prior to pregnancy...
June 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28678925/gestational-protein-restriction-increases-cardiac-connexin-43-mrna-levels-in-male-adult-rat-offspring
#18
Kamila Fernanda Rossini, Camila Andrea de Oliveira, Hércules Jonas Rebelato, Marcelo Augusto Marreto Esquisatto, Rosana Catisti
Background: The dietary limitation during pregnancy influences the growth and development of the fetus and offspring and their health into adult life. The mechanisms underlying the adverse effects of gestational protein restriction (GPR) in the development of the offspring hearts are not well understood. Objectives: The aim of this study was to evaluate the effects of GPR on cardiac structure in male rat offspring at day 60 after birth (d60). Methods: Pregnant Wistar rats were fed a normal-protein (NP, 17% casein) or low-protein (LP, 6% casein) diet...
June 29, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28674869/muscle-sympathetic-nerve-activity-peaks-in-the-first-trimester-in-healthy-pregnancy-a-longitudinal-case-study
#19
Sarah L Hissen, Khadigeh El Sayed, Vaughan G Macefield, Rachael Brown, Chloe E Taylor
OBJECTIVE AND METHODS: Muscle sympathetic nerve activity and baroreflex sensitivity were examined at rest before, during (weeks 6, 11, 17, 22, 25, 33 and 36) and after a normotensive pregnancy. RESULTS: Muscle sympathetic nerve activity is elevated during pregnancy with a large peak in the first trimester (Δ17 bursts/min) and a secondary peak in the third trimester (Δ11 bursts/min). Cardiac baroreflex sensitivity peaked in the first trimester (10 vs. 6 ms/mmHg pre-pregnancy), whereas sympathetic baroreflex sensitivity was greater throughout...
July 3, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/28674684/effect-of-fetal-sex-on-maternal-and-obstetric-outcomes
#20
REVIEW
Mohammed Al-Qaraghouli, Yu Ming Victor Fang
Fetal sex plays an important role in modifying the course and complications related to pregnancy and may also have an impact on maternal health and well-being both during and after pregnancy. The goal of this article is to review and summarize the findings from published research on physiologic and pathologic changes that may be affected by fetal sex and the effect of these changes on the maternal and obstetrical outcomes. This will help create awareness that fetal sex is not just a random chance event but an interactive process between the mother, the placenta, and the fetus...
2017: Frontiers in Pediatrics
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