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Cardiac pregnancy

Robert Kramer, Reed Quinn, Agneta Odera, Robert Groom, Nancy Boulanger, Eric Gunnoe, Russell White
Cardiac surgeons traveling to East Africa on humanitarian surgical missions treat a large number of people of all ages with rheumatic heart disease. A patient with severe mitral stenosis with pulmonary edema in the second trimester of pregnancy was treated successfully with closed mitral commissurotomy in a hospital in rural Kenya. An operation from the late 1940s may regain prominence more than 70 years later in areas of the world with a high incidence of rheumatic heart disease and limited cardiology and cardiac surgery resources...
November 2016: Annals of Thoracic Surgery
Shiraz A Maskatia, Rodrigo Ruano, Alireza A Shamshirsaz, Pouya Javadian, Joshua A Kailin, Michael A Belfort, Carolyn A Altman, Nancy A Ayres
INTRODUCTION: Twin-twin transfusion syndrome (TTTS) is the major cause for fetal demise in monochorionic diamniotic pregnancies. Estimated combined cardiac output (CCO) has not been studied in this setting. The primary aims of this study were to compare CCO in twin donor and recipient fetuses and assess differences in CCO before and after laser coagulation therapy. A secondary aim was to evaluate the relationship of CCO with perinatal mortality, defined as intrauterine or neonatal mortality (≤30 days of age) in fetuses that underwent laser coagulation therapy...
October 19, 2016: Echocardiography
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Vilas Magarkar, Pravir Lathi
Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome in pregnant and peripartum women. This report presents a rare case of spontaneous coronary artery dissection in early pregnancy managed by coronary angioplasty and, combined obstetric and cardiac care, resulting in the delivery of a normal infant through cesarean section.
September 2016: Indian Heart Journal
Elisabeth Leirgul, Kristoffer Brodwall, Gottfried Greve, Stein E Vollset, Henrik Holmstrøm, Grethe S Tell, Nina Øyen
OBJECTIVE: To investigate the association between pregestational or gestational diabetes and offspring risk of congenital heart defects and the association between large-for-gestational-age birth weight and risk of cardiac defects in offspring of diabetic women. METHODS: Information on pregestational and gestational diabetes, cardiac defects, and birth weight among all births in Norway in 1994-2009 was ascertained from the Medical Birth Registry of Norway, national health registries, and the Cardiovascular Disease in Norway project...
October 6, 2016: Obstetrics and Gynecology
Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
Kathirvel Gopalakrishnan, Amar S More, Gary D Hankins, Tatiana N Nanovskaya, Sathish Kumar
Approximately 20% of pregnant women smoke despite intentions to quit. Smoking cessation drugs, such as nicotine replacement therapy (NRT) and bupropion, are recommended treatments. Adverse cardiovascular outcomes in offspring have raised concerns about NRT's safety during pregnancy. However, the effect of bupropion is unknown. Using a rat model, we determined whether NRT and bupropion interventions during pregnancy are safer than continued smoking on offspring's cardiovascular function. Male offspring of controls and dams exposed to cigarette smoke (1...
October 12, 2016: Reproductive Sciences
Sabarinath, Sanket Shah, Lavanya, Rama Bhat
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
R S Monteiro, D P Dob, M R Cauldwell, M A Gatzoulis
Women with a single ventricle circulation palliated with the Fontan operation require specialist multidisciplinary management. We report 14 such cases with successful pregnancies and detail the pathophysiology encountered. A combined obstetric and cardiac service between Chelsea and Westminster Hospital and Royal Brompton Hospital provides care for women with heart disease, and maintains a prospective database of referred women. We searched this database for women with a known Fontan circulation and reviewed the case notes and electronic patient records between January 1994 and December 2015...
September 7, 2016: International Journal of Obstetric Anesthesia
Münïre Kübra Özgök-Kangal, Iclal Karatop-Cesur, Gökhan Akcali, Senol Yildiz, Günalp Uzun
BACKGROUND: Carbon monoxide (CO) poisoning is common in Turkey. Our department is the main provider of emergency hyperbaric oxygen therapy (HBOT) in Ankara and neighboring cities. In this study, we analyzed the characteristics of CO-poisoned patients who were referred by phone to our department for emergency HBOT. METHODS: We retrospectively reviewed the records of phone consultations with emergency departments regarding the need for treatment of CO-poisoned patients with HBOT between 14 January 2014 and 14 January 2015...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Gavin P Guy, Hua Z Ling, Mirian Machuca, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To evaluate the relationship between maternal cardiovascular parameters and neonatal birthweight and examine the potential value of these parameters in improving the prediction of small for gestational age (SGA) and large for gestational age (LGA) neonates provided by maternal characteristics and medical history. METHODS: In 2,835 singleton pregnancies maternal characteristics and medical history were recorded and maternal cardiovascular parameters were measured...
October 5, 2016: Ultrasound in Obstetrics & Gynecology
Rohan D'Souza, Candice K Silversides, Claire McLintock
The prothrombotic state of pregnancy increases the risk of thromboembolic complications and death in women with mechanical heart valves (MHVs). Although it is accepted that these women must be on therapeutic anticoagulation throughout pregnancy, competing maternal and fetal risks, as well as the lack of high-quality data from prospective studies, make the choice of the optimal method of anticoagulation challenging. Vitamin K antagonists (VKAs) are associated with fewer maternal complications, but conversely also the lowest live birth rates as well as warfarin-related embryopathy and fetopathy...
October 5, 2016: Seminars in Thrombosis and Hemostasis
Dimuthu Vinayagam, Sophie Bowe, Elaine Sheehan, Basky Thilaganathan, Asma Khalil
BACKGROUND: Due to the importance of cardiovascular dysfunction and advances in the development and use of non-invasive cardiac output (CO) monitoring devices, there is a growing interest in their use in the obstetric population. The aim of this study was to compare two commercially available, non-invasive CO monitors in the assessment of heart rate (HR), stroke volume (SV), CO, cardiac index (CI) and total peripheral resistance (TPR) in an obstetric population. METHODS: This was a prospective, comparative study including two groups...
October 6, 2016: Fetal Diagnosis and Therapy
Swati Vishwanathan, Michael Lucke, Indu G Poornima
A woman aged 22 years with a history of lupus presented in the 18th week of pregnancy with hypertensive emergency and flash pulmonary oedema. Bedside echocardiogram revealed severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 25% and pericardial effusion. Laboratories revealed hypocomplementemia, proteinuria, elevated C reactive protein and anti-DS-DNA, raising concern for a lupus flare. Cardiac MRI showed an acute intramyocardial oedematous process, consistent with lupus carditis, and further worsening of LVEF to 13%...
October 4, 2016: BMJ Case Reports
Qinghai Peng, Qichang Zhou, Ming Zang, Jiawei Zhou, Ran Xu, Tao Wang, Shi Zeng
OBJECTIVE: To screen and detect cortex gyration in fetuses with congenital heart disease (CHD) using Ultrasonography (US) during routine obstetric scans. METHODS: The depth of the Sylvian fissure (SF), parieto-occipital fissure (POF) and calcarine (CF) fissure were prospectively serially measured and compared in 45 fetuses with CHD and 45 normal fetuses. Cardiac hemodynamic parameters, including aortic valve diameter (AV), pulmonary valve diameter (PV), velocity time integral of the aortic valve (VTIav), and velocity time integral of the pulmonary valve (VTIpv), were recorded...
September 28, 2016: Prenatal Diagnosis
D Vinayagam, O Patey, B Thilaganthan, A Khalil
INTRODUCTION: There is a paucity of data regarding the accuracy, reliability and reproducibility of non-invasive cardiac output monitors in pregnancy. The aim of this study was to compare cardiac output estimations obtained by USCOM® against those obtained by 2-dimensional transthoracic echocardiography (TTE). METHODS: Prospective, observational study in which 114 healthy pregnant and postpartum women had haemodynamic indices obtained by USCOM® and TTE. Accuracy and precision statistics (Bland Altman analysis) are presented as bias, precision, 95% limits of agreement (LOA) and mean percentage difference (MPD)...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Vinayagam, Elena Mantovani, B Thilaganthan, A Khalil
BACKGROUND: Hypertensive disorders in pregnancy (HDP) are associated with altered maternal haemodynamics, which can be investigated using non-invasive methodologies. OBJECTIVE: To assess maternal haemodynamics using USCOM 1A® in patients presenting with non-medicated, hypertensive disorders of pregnancy and normotensive controls. METHODS: A prospective, nested case-control study in 65 patients presenting with unmedicated hypertension. The control population consisted of 400 subjects who did not have a history of hypertensive disorders...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Di Martino, S Zullino, D Casati, A S Grimaldi, V Sterpi, G Principato, M Garbin, E Ferrazzi
AIMS: To investigate maternal hemodynamic status in pregnancies complicated by IUGR and in the post-partum. METHODS: In this prospective study, we enrolled pregnant women between 24 and 38 weeks divided in severe and mild IUGR and a group of controls matched for gestational age. Severe IUGR was defined as abdominal circumference <5th centile and a Doppler velocimetry in umbilical artery42SD. Mild IUGR was defined as an abdominal circumference <10th centile and a Doppler velocimetry in umbilical artery <2SD...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Lo Presti, G Gagliardi, G M Tiralongo, I Pisani, B Vasapollo, G P Novelli, H Valensise
OBJECTIVE: The purpose of our study was to assess cardiac function in non-pregnant women with previous early preeclampsia before a second pregnancy to highlight the cardiovascular pattern, which may take a risk for recurrent preeclampsia. METHODS: Seventy-five normotensive patients with previous preeclampsia and 147 controls with a previous uneventful pregnancy were enrolled in a case control study and submitted to echocardiographic examination in the non-pregnant state 12-18 months after the first delivery...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Vinayagam, Juan Gutierrez, J Binder, B Thilaganathan, A Khalil
BACKGROUND: The increase in the prevalence of and the adverse risks to both mother and foetus associated with maternal obesity is a global concern. The adverse cardiovascular risk associated with obesity is well-known, however, there is a paucity of data assessing central haemodynamics in class 3 (morbid) obesity (BMI440 kg/m(2)) during pregnancy. OBJECTIVE: To compare the haemodynamic profile in women with class 3 maternal obesity against those with a normal BMI (20-30 kg/m(2)), using ultrasound-based, non-invasive haemodynamic monitoring...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
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