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Congenital heart disease pregnancy

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https://www.readbyqxmd.com/read/30104111/management-of-high-risk-cardiac-conditions-in-pregnancy-anticoagulation-severe-stenotic-valvular-disease-and-cardiomyopathy
#1
REVIEW
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
https://www.readbyqxmd.com/read/30102921/family-planning-and-pregnancy-management-in-adults-with-congenital-heart-disease
#2
REVIEW
Kelly K Shum K, Tripti Gupta T, Mary 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
https://www.readbyqxmd.com/read/30087824/subacute-infective-endocarditis-of-aortic-valve-during-pregnancy
#3
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
https://www.readbyqxmd.com/read/30087040/reducing-late-maternal-death-due-to-cardiovascular-disease-a-pragmatic-pilot-study
#4
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...
August 3, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/30082698/the-detrimental-effects-of-glucocorticoids-exposure-during-pregnancy-on-offspring-s-cardiac-functions-mediated-by-hypermethylation-of-bone-morphogenetic-protein-4
#5
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
https://www.readbyqxmd.com/read/30078353/noninvasive-prenatal-testing-for-congenital-heart-disease-cell-free-nucleic-acid-and-protein-biomarkers-in-maternal-blood
#6
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
https://www.readbyqxmd.com/read/30066535/environmental-and-individual-exposure-and-the-risk-of-congenital-anomalies-a-review-of-recent-epidemiological-evidence
#7
REVIEW
Silvia Baldacci, Francesca Gorini, Michele Santoro, Anna Pierini, Fabrizio Minichilli, Fabrizio Bianchi
INTRODUCTION: Congenital anomalies (CAs) represent one of the main cause of foetal death, infant mortality and morbidity, and long-term disability. CAs have been object of systematic registration activity for a long-time in many geographical areas in Europe and worldwide. CAs are often associated with disabilities of different types and severity, including the developed Countries worldwide. According to the World Health Organization (WHO), each year approximately 3,2 million of children worldwide are born with a CA and approximately 300,000 newborns with a diagnosis of birth defect die within the first 28 days of life...
May 2018: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/30055034/expanding-the-fetal-phenotype-prenatal-sonographic-findings-and-perinatal-outcomes-in-a-cohort-of-patients-with-a-confirmed-22q11-2-deletion-syndrome
#8
Erica Schindewolf, Nahla Khalek, Mark P Johnson, Juliana Gebb, Beverly Coleman, Terrence Blaine Crowley, Elaine H Zackai, Donna M McDonald-McGinn, Julie S Moldenhauer
22q deletion syndrome (22q11.2DS) is most often correlated prenatally with congenital heart disease and or cleft palate. The extracardiac fetal phenotype associated with 22q11.2DS is not well described. We sought to review both the fetal cardiac and extracardiac findings associated with a cohort of cases ascertained prenatally, confirmed or suspected to have 22q11.2DS, born and cared for in one center. A retrospective chart review was performed on a total of 42 cases with confirmed 22q11.2DS to obtain prenatal findings, perinatal outcomes and diagnostic confirmation...
July 28, 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/30027209/live-born-major-congenital-heart-disease-in-denmark-incidence-detection-rate-and-termination-of-pregnancy-rate-from-1996-to-2013
#9
Rebekka Lytzen, Niels Vejlstrup, Jesper Bjerre, Olav Bjørn Petersen, Stine Leenskjold, James Keith Dodd, Finn Stener Jørgensen, Lars Søndergaard
Importance: The occurrence of major congenital heart disease (CHD) is affected by several variables. Determining the development of the true incidence is critical to the establishment of proper treatment of these patients. Objective: To evaluate time trends in incidence, detection rate, and termination of pregnancy (TOP) rate of major CHD in fetuses in Denmark and assess the influence of the introduction of general prenatal screening in 2004. Design, Setting, and Participants: Nationwide, population-based, retrospective observational study in Denmark from 1996 to 2013 that included a consecutive sample of 14 688 live-born children and terminated fetuses diagnosed as having CHD...
July 18, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/30022113/pregnancy-outcomes-reported-during-the-13-year-treat-registry-a-descriptive-report
#10
Gary R Lichtenstein, Brian G Feagan, Uma Mahadevan, Bruce A Salzberg, Wayne Langholff, G James Morgan, Michael Safdi, Riikka Nissinen, François Taillard, William J Sandborn, Russell D Cohen
OBJECTIVES: We described pregnancy outcomes in Crohn's disease (CD) patients enrolled in the TREAT Registry who received infliximab before, or during pregnancy and those not treated with infliximab or any biologic agent. METHODS: In the TREAT Registry (1999-2012), pregnancy outcomes were analyzed from maternal and paternal patients exposed to infliximab ≤365 days (gestational exposure), >365 days (pre-gestational exposure) of pregnancy outcome or without infliximab exposure (non-biologic exposed)...
July 19, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/30009147/ebstein-anomaly-with-pregnancy-a-rare-case
#11
Nalini Sharma, Thiek Jion Lalnunnem, Megha Nandwani, Singh Ahanthem Santa, Baingen Warjari Synrang
Background: Ebstein anomaly is an uncommon, complex congenital malformation of the heart with prevalence of 0.3-0.5%. It occurs in 1% of congenital heart disease cases. It is characterized by dysplastic abnormalities of tricuspid valve which involves both basal and free attachments of the tricuspid valve leaflets, with downward displacement and elongation of the septal and anterior cusp which resulting in tricuspid regurgitation, the proximal part of the right ventricle is "atrialised", becoming thin walled and poorly contractile, along with an enlarged right atrium...
April 2018: Journal of Reproduction & Infertility
https://www.readbyqxmd.com/read/29982937/thalidomide-remodels-developing-heart-in-chick-embryo-discovery-of-a-thalidomide-mediated-hematoma-in-heart-muscle
#12
Pavitra Kumar, Harish A Kumar, Lakshmikirupa Sundaresan, Anuran Ghosh, Priyadarshan Kathirvel, Apurva Thilak, Yash T Katakia, Kavitha Sankaranarayanan, Suvro Chatterjee
Despite of medical disaster caused by thalidomide in 1960s, the drug came to clinical use again for the treatment of erythema nodosum leprosum (ENL) and multiple myeloma. Recently, a new generation of children affected by thalidomide intake by their mothers during pregnancy has been identified in Brazil. In the past few years, there is the great enhancement in our understanding of the molecular mechanisms and targets of thalidomide with the help of modern OMICS technologies. However, understanding of cardiac-specific anomalies in fetus due to thalidomide intake by the respective mother has not been explored fully...
July 7, 2018: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/29973095/is-there-a-role-for-cardiac-magnetic-resonance-imaging-during-pregnancy
#13
Matthew Romagano, Adetola Louis-Jacques, Joanne Quinones, Ronald Freudenberger, Laurie Fleming, John Smulian, Matthew Martinez
PURPOSE: To assess the role of cardiac magnetic resonance imaging (CMR) for the evaluation and management of women with cardiac disorders in pregnancy and postpartum. METHODS: Retrospective record review of women at a university-affiliated, single institution referred for CMR without contrast due to known or suspected cardiac disorders between January 2010 and December 2015. Medical records, echocardiogram and CMR reports were reviewed. Instances where clinical management was changed based on CMR findings were identified...
July 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29932991/fetal-diagnosis-of-right-cardiac-ventricular-aneurysms-a-report-of-three-cases
#14
Athiel Yoann, Barrois Mathilde, Bault Jean-Philippe, Cohen Laurence, Leroy Brigitte, Quibel Thibaud
Congenital ventricular aneurysms and diverticula are rare congenital heart diseases, currently accessible to prenatal diagnosis. Information on the natural course of ventricular aneurysm or diverticulum detected during fetal life is limited as there are only few case reports and case series enumerating the defect. We aimed to describe through three cases, the prenatal features and clinical outcomes of fetal cardiac aneurysms. The first one was diagnosed during the second trimestrer and spontaneous evolution was favorable...
June 19, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29922434/gestational-diabetes-influences-the-expression-of-hypertrophic-genes-in-left-ventricle-of-rat-s-offspring
#15
Elia Saragard Kermani, Zahra Nazari, Mehdi Mehdizadeh, Majid Shahbazi, Mohammad Jafar Golalipour
Objectives: Gestational diabetes increases the risk of congenital heart disease in the offspring, but the molecular mechanism underlying this process remains unclear. Therefore, the current study was conducted to assess the effects of induced gestational diabetes on expression of some involved genes in cardiac hypertrophy in the offspring of diabetic rats. Materials and Methods: Diabetes was induced in 40 adult Wistar rats by intraperitoneal injection of 45 mg/kg of streptozotocin...
May 2018: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29914284/congenital-heart-defects-the-10-year-experience-at-a-single-center
#16
Emine Aydin, Ebru Aypar, Ahmet Oktem, Ozgur Ozyuncu, Murat Yurdakok, Murat Guvener, Metin Demircin, M Sinan Beksac
OBJECTIVE: We aimed to evaluate congenital heart disease (CHD) cases according to EUROCAT subgroup classification that were diagnosed during the prenatal period in our center. METHODS: CHDs that were prenatally diagnosed using ultrasonography and confirmed by fetal echocardiography were reviewed over a 10-year period. Subgroup classification was finalized at the post-partum period in terms of the EUROCAT guide 1.3. Congenital heart defect subtypes and obstetric outcomes (gestational week at delivery, birth weight, gender, extracardiac structural abnormalities, karyotype results if performed) were analyzed...
July 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29907426/maternal-obesity-as-a-risk-factor-for-the-development-of-total-anomalous-pulmonary-venous-connection-in-their-offspring
#17
Evelyn G Alvarado-Terrones, Maryangel Perea-Cabrera, Miguel Klünder-Klünder, Begoña Segura-Stanford, Julio R Erdmenger-Orellana, Arturo Lopez-Yañez Blanco, Elizabeth Hernández-Carbajal, Javier T Granados Riverón, Leonardo J Mejía-Marín, Norma A Balderrabano-Saucedo, Alejandra Contreras-Ramos, Guadalupe Díaz-Rosas, Rocío Sánchez-Urbina
The incidence of total anomalous pulmonary venous connection (TAPVC) in the Caucasian population is 2.5/100,000 live births (LB), and the incidence in the Hispanic population is 19.8/100,000 LB. Without knowing the exact etiology for the development of congenital heart disease, our objective was to determine the maternal factors associated with the development of TAPVC. METHODS: 55 mother-child binomials with isolated TAPVC (group I) and 152 healthy mother-child binomials (group II) were included...
June 12, 2018: Archives of Medical Research
https://www.readbyqxmd.com/read/29876506/-will-she-live-a-long-happy-life-parents-concerns-for-their-children-with-fontan-circulation
#18
Karin du Plessis, Rebecca Peters, Ingrid King, Kirsty Robertson, Jonathan Mackley, Rachel Maree, Tracy Stanley, Louise Pickford, Brian Rose, Matthew Orchard, Helen Stewart, Yves d'Udekem
Background: Families of children at the worst end of the congenital heart disease endure a significant burden which is often not clearly delineated in the clinical literature. We examined the greatest concerns of parents whose children have a Fontan circulation. Methods: Parents ( N  = 107) of children in the Australian and New Zealand Fontan Registry completed online surveys with open-ended and closed questions. A qualitative method approach incorporating thematic analyses was used...
March 2018: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29848449/biological-versus-mechanical-heart-valve-prosthesis-during-pregnancy-in-women-with-congenital-heart-disease
#19
Heleen Lameijer, Ymkje J van Slooten, Monique R M Jongbloed, Martijn A Oudijk, Marlies A M Kampman, Arie P van Dijk, Marco C Post, Barbara J Mulder, Krystyna M Sollie, Dirk J van Veldhuisen, Tjark Ebels, Joost P van Melle, Petronella G Pieper
BACKGROUND: We evaluate pregnancy outcome and anticoagulation regimes in women with mechanical and biological prosthetic heart valves (PHV) for congenital heart disease. METHODS: Retrospective multicenter cohort studying pregnancy outcomes in an existing cohort of patients with PHV. RESULTS: 52 women had 102 pregnancies of which 78 pregnancies (46 women) ≥20 weeks duration (59 biological, 19 mechanical PHV). Miscarriages (n = 19, ≤20 weeks) occurred more frequently in women using anticoagulation (P < ...
October 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29808509/growth-patterns-and-cerebro-placental-hemodynamics-in-fetuses-with-congenital-heart-disease
#20
M J Mebius, S A B Clur, A S Vink, E Pajkrt, W S Kalteren, E M W Kooi, A F Bos, G J du Marchie Sarvaas, C M Bilardo
OBJECTIVES: Congenital heart disease (CHD) has been associated with a reduced fetal head circumference (HC). The underlying pathophysiological background remains undetermined. We aimed to define trends in fetal growth and cerebro-placental Doppler flow, and to investigate the association between head growth and cerebro-placental flow in fetuses with CHD. METHODS: Fetuses with CHD and serial measurements of HC, abdominal circumference (AC), middle cerebral artery pulsatility index (MCA-PI), umbilical artery pulsatility index (UA-PI), and cerebro-placental ratio (CPR) were included...
May 28, 2018: Ultrasound in Obstetrics & Gynecology
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