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Cardiac disease pregnancy

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https://www.readbyqxmd.com/read/28807713/opioid-drug-use-and-acute-cardiac-events-among-pregnant-women-in-the-united-states
#1
Hamisu M Salihu, Jason L Salemi, Anjali Aggarwal, Beverly F Steele, Ross C Pepper, Mulubrhan F Mogos, Muktar H Aliyu
BACKGROUND: Cardiovascular disease remains a leading cause of pregnancy-associated deaths in the United States (US). The extent to which increasing opioid use among pregnant women contributes to fatal cardiovascular events is unknown. We examine trends in opioid use among pregnant women over the previous decade, and the association between changes in temporal trends in opioid drug use and the incidence of acute cardiac events among mothers. METHODS: In this retrospective analysis of the Healthcare and Cost Utilization Project (HCUP), we utilized a two-stage stratified cluster sampling of all inpatient hospital discharges from non-federal hospitals between 01/01/2002 through 12/31/2014...
August 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28798077/cardiovascular-susceptibility-to-in-vivo-ischemic-myocardial-injury-in-male-and-female-rat-offspring-exposed-to-prenatal-hypoxia
#2
Amin Shah, Nobutoshi Matsumura, Anita Quon, Jude S Morton, Jason R B Dyck, Sandra T Davidge
Intrauterine growth restriction (IUGR) following prenatal hypoxia exposure leads to a higher risk of developing cardiovascular disease (CVD) in later life. Our aim was to evaluate cardiac susceptibility and its pathophysiological mechanisms following acute myocardial infarction (MI) in adult rat offspring exposed to prenatal hypoxia. Male and female rat offspring, which experienced normoxia (21% O2) or hypoxia (11% O2) in utero underwent sham or MI surgery at 12 weeks of age. Echocardiographic data revealed that both sexes had systolic dysfunction following MI surgery, independent of prenatal hypoxia...
September 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28796689/partnering-of-public-academic-and-private-entities-to-reestablish-maternal-mortality-review-in-georgia
#3
Michael K Lindsay, David Goodman, Seema Csukas, Pat Cota, Tammy L Loucks, Jane E Ellis
The pregnancy-related mortality ratio in the United States has increased over the past 25 years. Georgia's pregnancy-related mortality ratio is among the highest in the United States. Confronted with this harsh reality, Georgia reestablished maternal mortality review as one strategy to address its high maternal mortality. To achieve a comprehensive process for review of maternal deaths involved securing the knowledge, resources, and support of physician experts, public health agencies and professional organizations as well as representatives in the state legislature...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28780660/update-on-valvular-heart-disease-in-pregnancy
#4
REVIEW
Lucy M Safi, Sarah V Tsiaras
Valvular heart disease in women of childbearing age poses an increased risk of adverse maternal and fetal outcomes, and management in pregnancy can be challenging. Ideally, patients with suspected valvular disease should have preconception counseling by a multidisciplinary team including cardiologists with expertise in pregnancy and a maternal-fetal medicine specialist. Preconception planning should include a cardiac assessment of maternal risk, determination of frequency of surveillance, and a cardiovascular management plan during delivery...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28780659/preconception-counseling-for-women-with-cardiac-disease
#5
REVIEW
Mark A Clapp, Sarah N Bernstein
All providers who care for reproductive-aged women with cardiac disease should assess these patients' desires and plans for pregnancy at every encounter. For those considering pregnancy, preconception counseling, often performed by a maternal-fetal medicine specialist, can help patients understand the potential implications of pregnancy on their health and estimate the risks of an adverse cardiac event prior to conceiving. There are cardiac conditions, such as pulmonary hypertension and aortic stenosis, in which pregnancy may be contraindicated given the high morbidity and mortality; there are tools available to help quantify a patient's risk...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28765406/a-contemporary-review-of-peripartum-cardiomyopathy
#6
Peysh A Patel, Ashwin Roy, Rabeia Javid, John Aw Dalton
Peripartum cardiomyopathy reflects the presence of cardiac failure in the absence of determinable heart disease and occurs in late third trimester of pregnancy or up to 6 months postpartum. A full understanding of pathophysiological mechanisms is lacking, but excess prolactin levels, haemodynamic alterations, inflammation and nutritional deficiencies have all been implicated. Its clinical presentation has distinct overlap with physiological alterations in healthy pregnancy and this presents a diagnostic challenge...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28754745/cardiovascular-susceptibility-to-in-vivo-ischemic-myocardial-injury-in-male-and-female-rat-offspring-exposed-to-prenatal-hypoxia
#7
Amin Shah, Nobutoshi Matsumura, Anita Quon, Jude Sally Morton, Jason Dyck, Sandra Thomas Davidge
Intrauterine growth restriction following prenatal hypoxia exposure leads to a higher risk of developing cardiovascular disease in later life. Our aim was to evaluate cardiac susceptibility and its pathophysiological mechanisms following acute myocardial infarction (MI) in adult rat offspring exposed to prenatal hypoxia. Male and female rat offspring which experienced normoxia (21% O2) or hypoxia (11% O2) in utero underwent sham or MI surgery at 12 weeks of age. Echocardiographic data revealed that both sexes had systolic dysfunction following MI surgery, independent of prenatal hypoxia...
July 28, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28753499/non-invasive-cardiac-output-monitoring-nicom-%C3%A2-can-predict-the-evolution-of-uteroplacental-disease-results-of-the-prospective-handle-study
#8
Cathy Monteith, Lisa McSweeney, Colm R Breatnach, Anne Doherty, Lucy Shirren, Elizabeth C Tully, Patrick Dicker, Fergal D Malone, Afif El-Khuffash, Etaoin Kent
OBJECTIVES: We aimed to firstly identify the different haemodynamic profiles amongst nulliparous women who develop either gestational hypertension (GH), pre-eclampsia (PE), normotensive fetal growth restriction (FGR) versus unaffected pregnancies using non-invasive cardiac output monitoring (NICOM(®)). Our second primary objective was to assess the ability of NICOM(®) derived variables to predict the evolution of PE, GH and FGR. STUDY DESIGN: Low risk nulliparous women were enrolled in a single center prospective observational study...
July 20, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28751846/consensus-document-of-the-italian-association-of-hospital-cardiologists-anmco-italian-society-of-pediatric-cardiology-sicp-and-italian-society-of-gynaecologists-and-obstetrics-sigo-pregnancy-and-congenital-heart-diseases
#9
Innocenzo Bianca, Giovanna Geraci, Michele Massimo Gulizia, Gabriele Egidy Assenza, Chiara Barone, Marcello Campisi, Annalisa Alaimo, Rachele Adorisio, Francesca Comoglio, Silvia Favilli, Gabriella Agnoletti, Maria Gabriella Carmina, Massimo Chessa, Berardo Sarubbi, Maurizio Mongiovì, Maria Giovanna Russo, Sebastiano Bianca, Giuseppe Canzone, Marco Bonvicini, Elsa Viora, Marco Poli
The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the USA alone the number is estimated to exceed 1 million. In this population, many affected women reach reproductive age and wish to have children. While in many CHD patients pregnancy can be accomplished successfully, some special situations with complex anatomy, iatrogenic or residual pathology are associated with an increased risk of severe maternal and fetal complications...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28750406/a-high-fat-diet-during-pregnancy-and-lactation-induces-cardiac-and-renal-abnormalities-in-glut4-male-mice
#10
Michael Kruse, Ariana Fiallo, Jianling Tao, Katalin Susztak, Kerstin Amann, Ellen B Katz, Maureen J Charron
BACKGROUND/AIMS: Altered nutrients during the in utero (IU) and/or lactation (L) period predispose offspring to cardio-renal diseases in adulthood. This study investigates the effect of a high fat diet (HFD) fed to female mice during IU/L on gene expression patterns associated with heart and kidney failure and hypertension in male offspring. METHODS: Female wild type (WT) mice were fed either a HFD or control chow (C) prior to mating with males with a genetic heterozygous deletion of GLUT4 (G4+/-, a model of peripheral insulin resistance and hypertension) and throughout IU/L...
July 27, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28749853/the-icu-is-becoming-a-main-battlefield-for-severe-maternal-rescue-in-china-an-8-year-single-center-clinical-experience
#11
Liu Yuqi, Guoliang Tan, Shang Chengming, Sun Xuri
OBJECTIVES: To review the characteristics of and to identify the reasons for severe maternal admissions to the ICU. DESIGN: This was an analytical, observational, open, and retrospective study. SETTING: In our ICU. PATIENTS: A total of 487 severe maternal cases were reviewed during the 8-year study period of January 2009 to December 2016. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 487 severe maternal cases (12...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28743311/hypercapnic-respiratory-failure-during-pregnancy-due-to-polymyositis-related-respiratory-muscle-weakness-a-case-report
#12
Husain Shabbir Ali, Ibrahim Fawzy Hassan, Saibu George, Abdalrazig Elsadig Fadlelmula
BACKGROUND: Polymyositis is a rare medical disorder complicating pregnancy. Ventilatory muscle weakness leading to respiratory failure is an uncommon manifestation of this autoimmune disease. We report a case of life-threatening hypercapnic respiratory failure due to polymyositis-related respiratory muscle weakness in a pregnant woman. CASE PRESENTATION: A 31-year-old, African woman in her second trimester of pregnancy presented to the emergency department with fever, shortness of breath and muscle weakness...
July 26, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28739807/organisation-of-care-for-pregnancy-in-patients-with-congenital-heart-disease
#13
REVIEW
Jolien W Roos-Hesselink, Werner Budts, Fiona Walker, Julie F A De Backer, Lorna Swan, William Stones, Peter Kranke, Karen Sliwa-Hahnle, Mark R Johnson
Improvements in surgery have resulted in more women with repaired congenital heart disease (CHD) surviving to adulthood. Women with CHD, who wish to embark on pregnancy require prepregnancy counselling. This consultation should cover several issues such as the long-term prognosis of the mother, fertility and miscarriage rates, recurrence risk of CHD in the baby, drug therapy during pregnancy, estimated maternal risk and outcome, expected fetal outcomes and plans for pregnancy. Prenatal genetic testing is available for those patients with an identified genetic defect using pregestational diagnosis or prenatal diagnosis chorionic villus sampling or amniocentesis...
July 24, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28730459/fetal-programming-as-a-predictor-of-adult-health-or-disease-the-need-to-reevaluate-fetal-heart-function
#14
REVIEW
Joana O Miranda, Carla Ramalho, Tiago Henriques-Coelho, José Carlos Areias
Epidemiologic and experimental evidence suggests that adverse stimuli during critical periods in utero permanently alters organ structure and function and may have persistent consequences for the long-term health of the offspring. Fetal hypoxia, maternal malnutrition, or ventricular overloading are among the major adverse conditions that can compromise cardiovascular development in early life. With the heart as a central organ in fetal adaptive mechanisms, a deeper understanding of the fetal cardiovascular physiology and of the echocardiographic tools to assess both normal and stressed pregnancies would give precious information on fetal well-being and hopefully may help in early identification of special risk groups for cardiovascular diseases later in life...
July 20, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28719429/maternal-salvage-with-extracorporeal-life-support-lessons-learned-in-a-single-center
#15
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/28714608/selective-serotonin-reuptake-inhibitors-during-pregnancy-do-we-have-now-more-definite-answers-related-to-prenatal-exposure
#16
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/28706585/atrial-tachyarrhythmia-in-adult-congenital-heart-disease
#17
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/28694109/mathematical-modelling-of-the-maternal-cardiovascular-system-in-the-three-stages-of-pregnancy
#18
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/28681178/heart-disease-and-pregnancy
#19
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
#20
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
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