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Cardiac pregnancy

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https://www.readbyqxmd.com/read/29150149/pregnancy-and-heart-disease-pregnancy-associated-hypertension-and-peripartum-cardiomyopathy
#1
Tobias Jonathan Pfeffer, Denise Hilfiker-Kleiner
Cardiovascular diseases are major complications in pregnancy worldwide and the number of patients who develop cardiac problems during pregnancy is increasing. Pregnancy-associated hypertensive complications such as pre-eclampsia (PE) or peripartum cardiomyopathy (PPCM) are potentially life-threatening heart diseases emerging during pregnancy, under delivery or in the first postpartal months in previously healthy women. Both disease entities display substantial morbidity and mortality in the acute phase. Long-term effects are just beginning to be evaluated...
October 31, 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29145433/maternal-folic-acid-supplementation-and-dietary-folate-intake-and-congenital-heart-defects
#2
Baohong Mao, Jie Qiu, Nan Zhao, Yawen Shao, Wei Dai, Xiaochun He, Hongmei Cui, Xiaojuan Lin, Ling Lv, Zhongfeng Tang, Sijuan Xu, Huang Huang, Min Zhou, Xiaoying Xu, Weitao Qiu, Qing Liu, Yawei Zhang
BACKGROUND: It has been reported that folic acid supplementation before and/or during pregnancy could reduce the risk of congenital heart defects (CHDs). However, the results from limited epidemiologic studies have been inconclusive. We investigated the associations between maternal folic acid supplementation, dietary folate intake, and the risk of CHDs. METHODS: A birth cohort study was conducted in 2010-2012 at the Gansu Provincial Maternity & Child Care Hospital in Lanzhou, China...
2017: PloS One
https://www.readbyqxmd.com/read/29145328/endocarditis-due-to-abiotrophia-defectiva-a-biofilm-related-infection-associated-with-the-presence-of-fixed-braces-a-case-report
#3
Victoria Birlutiu, Rares Mircea Birlutiu
RATIONALE: Endocarditis with Abiotrophia defectiva represents 4.3% to 6% of all streptococcal endocarditis. The article presents diagnosis issues and the complexity of the treatment. PATIENT CONCERNS: We present the case of a female white patient, aged 26 years, who developed infectious endocarditis caused by A defectiva, in the last trimester of pregnancy, a biofilm-related infection associated with the presence of fixed braces. DIAGNOSES: The diagnosis of infectious endocarditis was confirmed by the cardiac ultrasound examination that revealed a voluminous vegetation on the mitral valve, and acute mitral regurgitation caused by chordae tendinae rupture, and also by isolating Abiotrophia defectiva from two positive blood cultures...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145274/diagnosis-of-fetal-megacystis-with-chromosomal-abnormality-by-2d-prenatal-ultrasound-a-case-report
#4
Fuman She, Shengwen Dong, Bibo Yuan, Xiaoli Gao
RATIONALE: The pathogenesis of fetal megacystis is divided into obstructive and nonobstructive. Megacystis combined with chromosomal abnormalities is rare and most of the cases are nonobstructive. PATIENT CONCERNS: The fetus showed posterior urethral obstructive megacystis with features of bladder enlargement, "keyhole" feature, and thick bladder wall. DIAGNOSES: Here, we present a case of fetal megacystis diagnosed by ultrasound at pregnancy week 15+2 and with multisystem abnormalities...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29138200/assessing-the-consequences-of-gestational-diabetes-mellitus-on-offspring-s-cardiovascular-health-mysweetheart-cohort-study-protocol-switzerland
#5
Stefano Di Bernardo, Yvan Mivelaz, Adina Mihaela Epure, Yvan Vial, Umberto Simeoni, Pascal Bovet, Sandrine Estoppey Younes, Arnaud Chiolero, Nicole Sekarski
INTRODUCTION: Gestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring's cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#6
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29130772/assessment-of-left-ventricular-function-using-the-myocardial-performance-index-in-term-fetuses-that-develop-intrapartum-compromise
#7
Amal A Alsolai, Larissa N Bligh, Ristan M Greer, Alexander Gooi, Sailesh Kumar
OBJECTIVE: To investigate the relationship between the prelabour left ventricular myocardial Performance Index (LVMPI) and intrapartum fetal compromise (IFC) in low risk term pregnancies. METHODS: A blinded, prospective observational cohort study at the Mater Mother's Hospital, Brisbane, Australia. A cohort of 284 women with uncomplicated singleton pregnancies underwent fortnightly ultrasound from 36 weeks until delivery. The LVMPI was assessed by conventional Doppler ultrasound and correlated with intrapartum outcomes...
November 12, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29122557/-maternal-deaths-due-to-anesthesia-complications-results-from-the-french-confidential-enquiry-into-maternal-deaths-2010-2012
#8
D Chassard
Over the period 2010-2012, maternal mortality linked to anesthesia accounted for 2% of maternal deaths, with no significant change since 2007-2009. Of the 7 maternal deaths analyzed by the expert committee, anesthetic complications were in 5 cases the main cause of death: 4 attributed to direct causes related to anesthetic procedures during childbirth and 1 to indirect cause in connection with an ENT complication during pregnancy. The anesthetic causes of maternal mortality were for the 2010-2012 period: cardiac arrest under spinal anesthesia during caesarean section, local anesthetic intoxication with unsuccessful resuscitation after cardiac arrest without intralipid administration, acute respiratory distress syndrome in the postpartum period after pulmonary aspiration during caesarean section, cardiac arrest during caesarean section under general anesthesia in a context of non-Hodgkin lymphoma with mediastinal syndrome, unsuccessful endotracheal intubation in a context of cellulitis of the oral cavity floor...
November 6, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29120514/assessment-of-venous-hemodynamics-and-volume-homeostasis-during-pregnancy
#9
EDITORIAL
W Gyselaers, M Spaanderman
Venous hemodynamics and volume homeostasis are important aspects of cardiovascular physiology, however today their relevance is still very much underappreciated. Their most important role is maintenance and control of venous return and as such cardiac output. A high flow/low resistance circulation, remaining constant under physiological circumstances, is mandatory for an uncomplicated course of pregnancy. In this paper, characteristics of normal and abnormal venous and volume regulating functions are discussed with respect to normal and pathologic outcomes of pregnancy, and current (non-invasive) methods to assess these functions are summarized...
November 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29116934/expectant-management-of-caesarean-scar-ectopic-pregnancy-a-systematic-review
#10
REVIEW
Pradeep Jayaram, Gbemisola Okunoye, Abdullah Awad Al Ibrahim, Rauf Ghani, Karim Kalache
AIM: The purpose of this review is to systematically review all the reported cases and case series of caesarean scar pregnancy (CSP) managed expectantly without any intervention in order to understand the outcomes of pregnancy which will guide clinicians and patients in making treatment choices. METHODS: An electronic search on PubMed, EMBASE and Cochrane databases and a manual search from references of the articles were performed. Studies were selected based on inclusion and exclusion criteria...
November 8, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29114815/maternal-use-of-antiepileptic-agents-during-pregnancy-and-major-congenital-malformations-in-children
#11
Rebecca L Bromley, Jennifer Weston, Anthony G Marson
Clinical Question: Is maternal use of antiepileptic drugs during pregnancy associated with major congenital malformations in children? Bottom Line: Certain antiepileptic drugs were associated with increased rates of congenital malformations (eg, spina bifida, cardiac anomalies). Lamotrigine (2.31% in 4195 pregnancies) and levetiracetam (1.77% in 817 pregnancies) were associated with the lowest risk and valproate was associated with the highest risk (10.93% in 2565 pregnancies) compared with the offspring of women without epilepsy (2...
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29113717/risk-factors-for-perinatal-cardiac-complications-in-pregnancy-with-pulmonary-hypertension
#12
He Zhao, Haofeng Zhang, Xiaohui Xu, Yaqin Wang, Hong Gu, Jun Zhang
OBJECTIVE: To analyze the risk factors for complications in pregnancy associated with pulmonary hypertension (PH) and to develop a logistic regression model to predict cardiac outcomes. METHODS: A retrospective analysis was performed on 249 women with PH, who were followed at the Beijing Anzhen Hospital, Affiliated to the Capital Medical University, from January 2012 to March 2015. All pregnancies were recorded. Overall, 214 cases of pulmonary arterial hypertension were identified...
September 7, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29111424/abnormal-mid-trimester-cardiac-strain-in-women-with-chronic-hypertension-predates-superimposed-preeclampsia
#13
Sajid Shahul, Hadi Ramadan, Ariel Mueller, Junaid Nizamuddin, Rabab Nasim, Joana Lopes Perdigao, Sireesha Chinthala, Avery Tung, Sarosh Rana
BACKGROUND: Chronic hypertension (cHTN) affects 7% of all pregnancies. We hypothesized that cHTN during pregnancy would be associated with abnormal myocardial strain patterns and adverse perinatal outcomes. METHODS: This was a retrospective cohort study of patients seen in a high-risk obstetrics clinic with cHTN. Parturients with a singleton pregnancy who had undergone an echocardiogram as part of routine clinical care were eligible. Clinical and demographic information was collected from medical records...
October 23, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29111423/maternal-cardiovascular-dysfunction-in-women-with-early-onset-preeclampsia-and-late-onset-preeclampsia-a-cross-sectional-study
#14
Sindhura Vaddamani, Anish Keepanasseril, Ajith Ananthakrishna Pillai, Binay Kumar
OBJECTIVES: To compare the cardiovascular changes associated with early onset (EOPE) and late onset (LOPE) subtypes of preeclampsia. METHODS: A prospective matched cross-sectional study involving 50 women each with early and late onset subtypes of preeclampsia conducted in a tertiary hospital in South India. Cardiac function and remodelling were assessed by conventional 2D, M-mode and doppler echocardiography. RESULTS: Women with EOPE had a significantly more altered left ventricular (LV) geometry, global LV diastolic dysfunction, impairment in myocardial contractility (40% vs...
October 25, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#15
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy (HDP) is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in HDP considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVES: This study aimed to examine cardiovascular parameters in a cohort of patients affected by HDP according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of HDP...
November 1, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29102365/pregnancy-in-women-with-a-cardiomyopathy-outcomes-and-predictors-from-a-retrospective-cohort
#16
Gilles Billebeau, Martin Etienne, Riadh Cheikh-Khelifa, Daniele Vauthier-Brouzes, Estelle Gandjbakhch, Richard Isnard, Jacky Nizard, Michel Komajda, Marc Dommergues, Philippe Charron
BACKGROUND: Pregnancies in women with pre-existing cardiomyopathies are considered at high risk for complications. However, few data are available to characterize their natural history and predict the outcome. AIMS: Our aim was to evaluate the prevalence and predictors of acute cardiac and obstetric events in women with a cardiomyopathy during pregnancy, excluding peripartum cardiomyopathy. METHODS: In this retrospective study in a referral centre for cardiomyopathies, we included 43 consecutive pregnancies in 36 women with dilated, hypertrophic, arrhythmogenic right ventricular or tachycardia-induced cardiomyopathy, or left ventricular non-compaction...
October 25, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29101986/acr-appropriateness-criteria-%C3%A2-multiple-gestations
#17
Phyllis Glanc, David A Nyberg, Nadia J Khati, Sandeep Prakash Deshmukh, Kika M Dudiak, Tara Lynn Henrichsen, Liina Poder, Thomas D Shipp, Lynn Simpson, Therese M Weber, Carolyn M Zelop
Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29098625/c-ebpb-cited4-in-exercised-heart
#18
Shengguang Ding, Tianyi Gan, Meiyi Song, Qiying Dai, Haitao Huang, Yiming Xu, Chongjun Zhong
C/EBPB is a crucial transcription factor, participating in a variety of biological processes including cell proliferation, differentiation and development. In the cardiovascular system, C/EBPB-CITED4 signaling is known as a signaling pathway mediating exercise-induced cardiac growth. After its exact role in exercised heart firstly reported in 2010, more and more evidence confirmed that. MicroRNA (e.g. miR-222) and many molecules (e.g. Alpha-lipoic acid) can regulate this pathway and then involve in the cardiac protection effect induced by endurance exercise training...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29097198/liver-lacerations-as-a-complication-of-cpr-during-pregnancy
#19
Timothy R Cox, Sarah D Crimmins, Allison M Shannon, Kristin L Atkins, Ronald Tesoriero, Andrew M Malinow
AIM: Cardiac arrest in peripartum patients is a rare but devastating event; reported rates in the literature range from 0.019% to 0.0085%. In the general population, a well-described complication of cardiopulmonary resuscitation (CPR), liver laceration and injury, is reported at a rate of between 0.5-2.9% after CPR. Liver laceration rate among peripartum patients receiving CPR has not been well-studied. We sought to find the rate of liver lacerations in the peripartum population associated with CPR, with the hypothesis that the rate would be higher than in the general population...
October 31, 2017: Resuscitation
https://www.readbyqxmd.com/read/29094488/maternal-report-of-fever-from-cold-or-flu-during-early-pregnancy-and-the-risk-for-noncardiac-birth-defects-national-birth-defects-prevention-study-1997-2011
#20
Dorothy Kim Waller, Syed Shahrukh Hashmi, Adrienne T Hoyt, Hao T Duong, Sarah C Tinker, Michael Shayne Gallaway, Richard S Olney, Richard H Finnell, Jacqueline Tauber Hecht, Mark A Canfield
BACKGROUND: As maternal fever affects approximately 6-8% of early pregnancies, it is important to expand upon previous observations of an association between maternal fever and birth defects. METHODS: We analyzed data from the National Birth Defects Prevention Study, a multistate, case-control study of major structural birth defects. Telephone interviews were completed by mothers of cases (n = 17,162) and controls (n = 10,127). Using multivariable logistic regression, we assessed the association between maternal self-report of cold or flu with fever and cold or flu without fever during early pregnancy and 30 categories of non-cardiac birth defects...
November 2, 2017: Birth defects research
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