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Congenital heart disease pregnancy

Anne S Siegmund, Marlies A M Kampman, Martijn A Oudijk, Barbara J M Mulder, Gertjan Tj Sieswerda, Steven V Koenen, Yoran M Hummel, Monique W M de Laat, Krystyna M Sollie-Szarynska, Henk Groen, Arie P J van Dijk, Dirk J van Veldhuisen, Caterina M Bilardo, Petronella G Pieper
OBJECTIVE: Pregnant women with congenital heart disease (CHD) have an increased chance of abnormal uteroplacental flow (UPF) measured from second trimester onwards. This is related to pregnancy complications affecting mother and baby. Maternal right ventricular (RV) dysfunction has been suggested as predisposing factor. First trimester UPF screening, followed by therapeutic strategies, is effective in preventing pregnancy complications. The study aim was to relate first trimester UPF measurements to pre-pregnancy maternal cardiac function and pregnancy complications...
October 17, 2018: Ultrasound in Obstetrics & Gynecology
Anne-Sophie Sillesen, Anna Axelsson Raja, Christian Pihl, Ruth Ottilia Birgitta Vøgg, Morten Hedegaard, Pernille Emmersen, Karin Sundberg, Ann Tabor, Cathrine Vedel, Helle Zingenberg, Charlotte Kruse, Charlotte Wilken-Jensen, Tina Holm Nielsen, Finn Stener Jørgensen, Dorthe Lisbeth Jeppesen, Lars Søndergaard, Pia R Kamstrup, Børge G Nordestgaard, Ruth Frikke-Schmidt, Niels Vejlstrup, Heather A Boyd, Henning Bundgaard, Kasper Iversen
Congenital heart diseases (CHDs) are reported in 0.8% of newborns. Numerous factors influence cardiovascular development and CHD prevalence, and possibly also development of cardiovascular disease later in life. However, known factors explain the probable etiology in only a fraction of patients. Past large-scale population-based studies have made invaluable contributions to the understanding of cardiac disease, but none recruited participants prenatally and focused on the neonatal period. The Copenhagen Baby Heart Study (CBHS) is a population-based study of the prevalence, spectrum, and prognosis of structural and functional cardiac abnormalities...
October 10, 2018: European Journal of Epidemiology
Charlène Bredy, François-Pierre Mongeon, Line Leduc, Annie Dore, Paul Khairy
Atrial septal defect (ASD) is the most common form of congenital heart disease. Left-to-right shunting leads to right ventricular (RV) volume overload with excessive pulmonary blood flow. Complications include exercise intolerance, pulmonary vascular disease, RV dysfunction, paradoxical thromboemboli, and atrial arrhythmias. Women with coexisting severe pulmonary hypertension should be counselled against pregnancy due to high incidence of maternal and fetal morbidity and mortality. In the absence of pulmonary hypertension, pregnancy is generally well tolerated in the setting of an ASD...
September 2018: Journal of Thoracic Disease
Diana S Wolfe, Afshan B Hameed, Cynthia C Taub, Ali N Zaidi, Anna E Bortnick
Over the last three years, multiple reports have been published in the United States demonstrating the upward trends in maternal mortality [1] [2] [3]. This increase in maternal death rate is greatly driven by the cardiovascular disease related deaths. Cardiovascular disease accounted for 15.5% of maternal deaths in the USA between years 2011-2013. The United Nations Millennium Development Goal of a 75% reduction in maternal mortality has not been achieved. This may be explained by the increasing number of women with congenital heart disease (CHD) reaching reproductive age and a higher prevalence of chronic medical diseases that puts women at risk for cardiac complications, as pregnancy is a physiologic stress test [1]...
September 29, 2018: American Journal of Obstetrics and Gynecology
Angela J Dawson, Yordanka Krastev, William A Parsonage, Michael Peek, Karin Lust, Elizabeth A Sullivan
OBJECTIVE: Cardiac disease in pregnancy is a leading cause of maternal death in high-income countries. Evidence-based guidelines to assist in planning and managing the healthcare of affected women is lacking. The objective of this research was to produce the first qualitative metasynthesis of the experiences of pregnant women with existing or acquired cardiac disease to inform improved healthcare services. METHOD: We conducted a systematic search of peer-reviewed publications in five databases to investigate the decision-making processes, supportive strategies and healthcare experiences of pregnant women with existing or acquired cardiac disease, or of affected women contemplating pregnancy...
September 28, 2018: BMJ Open
Hidetoshi Mezawa, Ai Tomotaki, Kiwako Yamamoto-Hanada, Kazue Ishitsuka, Tadayuki Ayabe, Mizuho Konishi, Mayako Saito, Limin Yang, Narufumi Suganuma, Fumiki Hirahara, Shoji F Nakayama, Hirohisa Saito, Yukihiro Ohya
BACKGROUND: The aims of the present report were to estimate the prevalence of congenital anomalies (CAs) among infants in Japan using data from the Japan Environment and Children's Study (JECS) and to evaluate the validity of CA classification within JECS. METHODS: Data on CAs were collected at delivery and at age 1 month from the medical records of 101,825 infants at 15 regional centers. The analyses focused on 61 CAs, selected on the basis of reported associations with environmental exposure...
September 22, 2018: Journal of Epidemiology
Megan E B Clowse, Amanda M Eudy, Elizabeth Kiernan, Matthew R Williams, Bonnie Bermas, Eliza Chakravarty, Lisa R Sammaritano, Christina D Chambers, Jill Buyon
Objective: To survey an international sample of providers to determine their current practices for the prevention, screening, and treatment of congenital heart block (CHB) due to maternal Ro/SSA antibodies. Methods: A survey was designed by the organizing committee of the 9th International Conference of Reproduction, Pregnancy and Rheumatic Diseases. It was sent to attendants of the conference and authors of recent publications or abstracts at ACR 2012, 2013 or 2014 on rheumatic diseases and pregnancy...
July 1, 2018: Rheumatology
Lingling Wang, Xiaomei Xiang, Baibing Mi, Hui Song, Min Dong, Shuiping Zhang, Yuxue Bi, Yaling Zhao, Qiang Li, Qi Zhang, Li Zhang, Hong Yan, Duolao Wang, Shaonong Dang
Background: The aim of this study was to investigate an association between birth defects and exposure to sulfur dioxide (SO2), nitrogen dioxide (NO2) and particles ≤10 μm in an aerodynamic diameter (PM10) during early pregnancy in Xi'an, China. Methods: Birth defect data were from the Birth Defects Monitoring System of Xi'an, and data on ambient air pollutants during 2010-15 were from the Xi'an Environmental Protection Bureau. A generalized additive model (GAM) was used to investigate the relationship between birth defects and ambient air pollutants...
August 18, 2018: Journal of Public Health
Margarita Brida, Gerhard-Paul Diller, Heba Nashat, Maja Strozzi, Davor Milicic, Helmut Baumgartner, Michael A Gatzoulis
Congenital heart disease (CHD) is the most common inborn defect. Due to advances in paediatric care, surgical, and catheter procedures the number of adults with CHD has grown remarkably in recent years. Most of these patients, however, have residua from their original operation/s and require life-long care, many of them are subjected to further haemodynamic and electrophysiological interventions during adulthood. While such re-do surgical or catheter interventions together with device therapy and transplantation play a key therapeutic role, increasingly, adults with CHD require drug therapy for late complications namely heart failure (HF), arrhythmias, pulmonary and systemic hypertension, thromboembolic events, etc...
August 21, 2018: European Heart Journal
Shiyu Luo, Dahua Meng, Qifei Li, Xuehua Hu, Yuhua Chen, Chun He, Bobo Xie, Shangyang She, Yingfeng Li, Chunyun Fu
BACKGROUND: Congenital heart defects (CHD), as the most common congenital anomaly, have been reported to be associated with chromosomal abnormalities. Currently, patients with CHD are routinely offered karyotyping and chromosomal microarray (CMA) testing, but the genotype-phenotype relationship has not yet been fully established. OBJECTIVE: To determine the type and frequency of chromosomal abnormalities in fetuses with CHD and to analyze pregnancy outcomes of fetuses with heart abnormalities caused by different genetic factors...
August 20, 2018: Arquivos Brasileiros de Cardiologia
Jennifer A Courtney, James F Cnota, Helen N Jones
Congenital heart disease (CHD) is the most common birth defect, affecting ~1% of all live births (van der Linde et al., 2011). Despite improvements in clinical care, it is the leading cause of infant mortality related to birth defects (Yang et al., 2006) and burdens survivors with significant morbidity (Gilboa et al., 2016). Furthermore, CHD accounts for the largest proportion (26.7%) of birth defect-associated hospitalization costs-up to $6.1 billion in 2013 (Arth et al., 2017). Yet after decades of research with a primary focus on genetic etiology, the underlying cause of these defects remains unknown in the majority of cases (Zaidi and Brueckner, 2017)...
2018: Frontiers in Physiology
Stephanie Brun, Emilie L'Ecuyer, Annie Dore, François-Pierre Mongeon, Aude-Christine Guedon, Line Leduc
RATIONALE: It is known that fetal growth is usually proportional to left-sided cardiac output (CO) which parallels the right-sided CO and that congenital right-sided lesions are usually associated with better perinatal outcomes than left-sided lesions. OBJECTIVE: Our objective was to document whether newborns from mothers with severe residual pulmonary valve insufficiency (PI) after surgical tetralogy of Fallot (TOF) or pulmonary stenosis (PS) correction have lower birth weight (BW) than newborns from mothers with absent, mild or moderate PI...
August 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
Hong-Yan Zhan, Feng-Qin Xu, Chuan-Xi Liu, Gang Zhao
BACKGROUND: In recent years, pulmonary artery blood flow acceleration time (AT) has been believed to be applicable in the examination of fetal lung development. OBJECTIVES: This study aims to evaluate the clinical significance of pulmonary artery blood flow AT as a parameter in monitoring of fetal pulmonary artery pressure. MATERIAL AND METHODS: A total of 31 fetuses in midor late-term pregnancy with tricuspid regurgitation were set as the study group (congenital heart disease with a tricuspid regurgitation pressure difference of more than 20 mm Hg was excluded)...
August 21, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Hong-Yu Duan, Kai-Yu Zhou, Tao Wang, Yi Zhang, Yi-Fei Li, Yi-Min Hua, Chuan Wang
Background: Valproic acid (VPA) exposure during pregnancy has been proven to contribute to congenital heart disease (CHD). Our previous findings implied that disruption of planar cell polarity (PCP) signaling pathway in cardiomyocytes might be a factor for the cardiac teratogenesis of VPA. In addition, the teratogenic ability of VPA is positively correlated to its histone deacetylase (HDAC) inhibition activity. This study aimed to investigate the effect of the VPA on cardiac morphogenesis, HDAC1/2/3, and PCP key genes (Vangl2/Scrib/Rac1), subsequently screening out the specific HDACs regulating PCP pathway...
September 5, 2018: Chinese Medical Journal
Emily Lau, Doreen DeFaria Yeh
Cardiovascular disease contributes to approximately one third of all maternal mortality and remains a significant source of peri‑ and postpartum morbidity. As more women at risk for and with cardiovascular disease are desiring pregnancy, it is imperative that general cardiologists and obstetricians participate collaboratively in preconception counseling and are more facile with management of these lesions during peri‑ and postpartum periods. This review aims to address this growing need and highlights the management strategies for some of the major high risk cardiac conditions encountered during pregnancy including anticoagulation, cardiomyopathies as well as severe mitral and aortic stenosis; aortopathy, pulmonary hypertension, and severe congenital heart lesions will not be addressed...
July 22, 2018: Trends in Cardiovascular Medicine
Kelly K Shum, Tripti Gupta, Mary M Canobbio, Jennifer Durst, Sangeeta B Shah
With advances in congenital heart disease management, there are an increasing number of women reaching reproductive age. Pregnancy results in a surge of hormones and increased demands on both the cardiovascular (CV) and respiratory systems. Depending on the heart defect and the treatments the mother has undergone, these hemodynamic changes can result in an increased risk of maternal CV events and an increased risk of fetal morbidity and mortality. Thus, it is important to have a comprehensive approach to adult congenital heart disease patients involving pre-pregnancy planning in addition to diligent peri- and post-partum care...
August 10, 2018: Progress in Cardiovascular Diseases
Muhammad Wajih Ullah, Sunita Lakhani, Sunder Sham, Fariha Ashraf, Wardah Siddiq, Tariq Siddiqui
Bacterial infective endocarditis is a rare but a life-threatening infection during pregnancy. Infective endocarditis during pregnancy is often associated with a congenital heart condition or an earlier history of rheumatic heart disease. In pregnant women with infective endocarditis, the maternal and fetal mortality rate can reach as high as 33% and 29%, respectively. In most cases, infective endocarditis runs a subacute course and involves the mitral valve, nonetheless, rarely it can involve the aortic valve as well...
June 5, 2018: Curēus
Karen Sliwa, Feriel Azibani, Johann Baard, Ayesha Osman, Liesl Zühlke, Anthony Lachmann, Elena Libhaber, Ashley Chin, Mpiko Ntsekhe, Priya Soma-Pillay, Mark R Johnson, Jolien Roos-Hesselink, John Anthony
BACKGROUND: Late maternal mortality (up-to 1-year postpartum) is poorly reported globally and is commonly due to cardiovascular disease (CVD). We investigated targeted interventions aiming at reducing peripartum heart failure admission and late maternal death. METHODS AND RESULTS: Prospective single-centre study of 269 peripartum women presenting with CVD in pregnancy, or within 6-months postpartum. Both cardiac disease maternity (CDM) Group-I and Group-II were treated by a dedicated cardiac-obstetric team...
December 1, 2018: International Journal of Cardiology
Jieying Peng, Yuhao Zhou, Zhiyu Zhang, Zhiming Wang, Lingtong Gao, Xiao Zhang, Zhou Fang, Guangyao Li, Huaiyan Chen, Hongxing Yang, Lu Gao
The intra-uterine and external environmental factors not only affect the early development of fetuses, their interaction with genesis will also substantially program the physiological functions of offspring throughout life. Synthetic glucocorticoid (GC) is widely used for the management of women at risk of preterm birth or undergone autoimmune diseases. However, excess GC might cause a number of chronic diseases in later life. In the present study, we set up a programming rat model by daily injection of dexamethasone (DEX) since 14...
August 6, 2018: Cell Death & Disease
Orsolya Biró, János Rigó, Bálint Nagy
CONTEXT: Congenital heart disease (CHD) is the most common fetal malformation. Prenatal ultrasonography is routinely applied for the screening of CHD but many factors influence its diagnostic accuracy. The introduction of new biomarkers could facilitate the identification of high-risk pregnancies. OBJECTIVE: In our review, our aim was to collect expression studies of cell-free nucleic acids and proteins in maternal circulation. Syndromic CHDs which can be detected by noninvasive prenatal testing (NIPT) techniques were also discussed...
August 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
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