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Maternal Cardiac Disease

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https://www.readbyqxmd.com/read/28498066/atrial-fibrillation-in-pregnancy-a-growing-challenge
#1
Vasiliki Katsi, Georgios Georgiopoulos, Maria Marketou, Dimitrios Oikonomou, Fragiskos Parthenakis, Thomas Makris, Petros Nihoyannopoulos, P Vardas, Dimitris Tousoulis
Atrial fibrillation (AF) constitutes a relatively infrequent pregnancy complication, which may be a therapeutic Gordian knot. Indeed, sparse data exist regarding the prevalence, prognosis and management of AF during pregnancy. In general, AF occurs as a benign, self-limited arrhythmia but occasionally may have severe hemodynamic consequences in pregnant patients suffering from heart failure, congenital heart disease, or other comorbidities. Extra-cardiac causes of AF should always be meticulously excluded. Treatment decisions are difficult, since medications may cross placental barrier and potentially affect fetal growth and organogenesis or even result in fetal bradyarrhythmias...
May 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28491125/indirect-maternal-deaths-uk-and-global-perspectives
#2
Manisha Nair, Catherine Nelson-Piercy, Marian Knight
Indirect maternal deaths outnumber direct deaths due to obstetric causes in many high-income countries, and there has been a significant increase in the proportion of maternal deaths due to indirect medical causes in low- to middle-income countries. This review presents a detailed analysis of indirect maternal deaths in the UK and a perspective on the causes and trends in indirect maternal deaths and issues related to care in low- to middle-income countries. There has been no significant decrease in the rate of indirect maternal deaths in the UK since 2003...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28470155/-the-relationships-among-perceived-parental-bonding-illness-perception-and-anxiety-in-adult-patients-with-congenital-heart-diseases
#3
Nayeon Shin, Youha Jang, Younhee Kang
PURPOSE: The purposes of this study were to identify the relationships among perceived parental bonding, illness perception, and anxiety and to determine the influences of perceived parental bonding and illness perception on anxiety in adult patients with congenital heart diseases. METHODS: In this study a descriptive correlational design with survey method was utilized. The participants were 143 adult patients with congenital heart disease being cared for in the cardiology out-patient clinic of A medical center...
April 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28469102/prevalence-of-congenital-heart-disease-among-infants-from-2012-to-2014-in-langfang-china
#4
Peng-Fei Sun, Gui-Chun Ding, Min-Yu Zhang, Sheng-Nan He, Yu Gao, Jian-Hua Wang
BACKGROUND: Congenital heart disease (CHD) is the most common congenital malformations with high mortality and morbidity. The prevalence of CHD reported previously ranged from 4 per 1000 live births to 50 per 1000 live births. In this cross-sectional study, we aimed to document the prevalence of CHD in Langfang district of Hebei Province, China by analyzing data collected by hospitals located in 11 the counties of the district, as supported by a public health campaign. METHODS: A total of 67,718 consecutive 3-month-old infants were included from July 19, 2012 to July 18, 2014...
May 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28439937/maternal-nutrient-restriction-during-pregnancy-and-lactation-leads-to-impaired-right-ventricular-function-in-young-adult-baboons
#5
Anderson H Kuo, Cun Li, Hillary F Huber, Matthias Schwab, Peter W Nathanielsz, Geoffrey D Clarke
KEY POINTS: Maternal nutrient restriction induces intrauterine growth restriction (IUGR) and leads to heightened cardiovascular risks later in life. We report right ventricular (RV) filling and ejection abnormalities in IUGR young adult baboons using cardiac magnetic resonance imaging. Both functional and morphological indicators of poor RV function were seen, many of which were similar to effects of ageing, but also with a few key differences. We observed more pronounced RV changes compared to our previous report of the left ventricle, suggesting there is likely to be a component of isolated RV abnormality in addition to expected haemodynamic sequelae from left ventricular dysfunction...
April 25, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28426617/clinical-updates-in-women-s-health-care-summary-arrhythmias-primary-and-preventive-care-review
#6
Brittany S Fuller, Michele D Voeltz
Obstetrician-gynecologists often are the sole providers of health care to female patients. Because cardiovascular disease is the leading cause of death in women in the United States, obstetrician- gynecologists must be aware of the risk factors, symptoms, and signs of cardiovascular disease and arrhythmia. Furthermore, they must be prepared to identify and treat common types of arrhythmia in this population and refer patients to cardiology for specialized care. Understanding the role of pregnancy among women with arrhythmia is critically important to optimize both maternal and fetal outcomes...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28425976/prenatal-exposure-to-a-maternal-high-fat-diet-affects-histone-modification-of-cardiometabolic-genes-in-newborn-rats
#7
Bijaya Upadhyaya, Tricia Larsen, Shivon Barwari, Eli J Louwagie, Michelle L Baack, Moul Dey
Infants born to women with diabetes or obesity are exposed to excess circulating fuels during fetal heart development and are at higher risk of cardiac diseases. We have previously shown that late-gestation diabetes, especially in conjunction with a maternal high-fat (HF) diet, impairs cardiac functions in rat-offspring. This study investigated changes in genome-wide histone modifications in newborn hearts from rat-pups exposed to maternal diabetes and HF-diet. Chromatin-immunoprecipitation-sequencing revealed a differential peak distribution on gene promoters in exposed pups with respect to acetylation of lysines 9 and 14 and to trimethylation of lysines 4 and 27 in histone H3 (all, false discovery rate, FDR < 0...
April 20, 2017: Nutrients
https://www.readbyqxmd.com/read/28416028/attitudes-and-perceptions-of-pregnant-women-with-chd-results-of-a-single-site-survey
#8
Aarthi Sabanayagam, David Briston, Ali N Zaidi
Introduction CHD occurs in about 1% of the United States population, and is now the most common cardiac condition affecting women during pregnancy. METHODS: An anonymous, single-site, cross-sectional, 50-question survey was performed at a national Adult Congenital Heart Disease conference to assess the level of knowledge, attitudes, and perceptions regarding cardiac care during pregnancy in women with CHD. RESULTS: A total of 77 women completed the survey. Among them, 50% (n=39) had moderate and 38% (n=29) had severely complex disease; 30% (n=23) of women were told that pregnancy was contraindicated given their underlying cardiac condition...
April 18, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28413284/combined-mitral-and-aortic-stenosis-in-parturient-anesthesia-management-for-labor-and-delivery
#9
Manish Kela, Madhvi Buddhi
Maternal heart disease complicates 0.2-3% of pregnancies. The optimal management of the pregnant patient with cardiac disease depends on the co-operative efforts of the obstetrician, the cardiologist and the anesthesiologist involved in peripartum care. A comprehensive understanding of physiology of pregnancy and pathophysiology of underlying cardiac disease is of primary importance in provision of obstetric analgesia or anesthesia for these high-risk groups of patients. We report a successful and uncomplicated use of epidural anesthesia for labor and delivery in patient with combined aortic and mitral stenosis...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412993/paediatric-onset-coronary-artery-anomalies-in-pregnancy-a-single-centre-experience-and-systematic-literature-review
#10
Michelle Keir, Catriona Bhagra, Debra Vatenmakher, Francisca Arancibia-Galilea, Katrijn Jansen, Norihisa Toh, Candice K Silversides, Jack Colman, Samuel C Siu, Mathew Sermer, Andrew M Crean, Rachel M Wald
OBJECTIVES: Individuals with childhood-onset coronary artery anomalies are at increased risk of lifelong complications. Although pregnancy is thought to confer additional risk, a few data are available regarding outcomes in this group of women. We sought to define outcomes of pregnancy in this unique population. METHODS: We performed a retrospective survey of women with paediatric-onset coronary anomalies and pregnancy in our institution, combined with a systematic review of published cases...
April 17, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28412849/maternal-hemodynamic-changes-and-predictors-of-poor-obstetric-outcome-in-women-with-rheumatic-heart-disease-a-five-year-observational-study
#11
Mohamed Rezk, Osama Elkelani, Abdelhamid Shaheen, Awni Gamal, Hassan Badr
OBJECTIVE: to assess prospectively the maternal cardiovascular hemodynamic changes and obstetric outcome in women with rheumatic heart disease (RHD) and to detect predictors of poor outcome. METHODS: This prospective observational study included 204 pregnant patients with RHD who were divided into two groups; successful pregnancy group with living fetus (n = 126) and poor obstetric outcome group with fetal or neonatal loss (n = 78). Hemodynamic changes, maternal and fetal outcome were assessed and recorded...
April 16, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28412087/pregestational-type-2-diabetes-mellitus-induces-cardiac%C3%A2-hypertrophy-in-the-murine-embryo-through-cardiac%C3%A2-remodeling-and-fibrosis
#12
Xue Lin, Penghua Yang, E Albert Reece, Peixin Yang
BACKGROUND: Cardiac hypertrophy is highly prevalent in patients with type 2 diabetes mellitus. Experimental evidence has implied that pregnant women with type 2 diabetes mellitus and their children are at an increased risk of cardiovascular diseases. Our previous mouse model study revealed that maternal type 2 diabetes mellitus induces structural heart defects in their offspring. OBJECTIVE: This study aims to determine whether maternal type 2 diabetes mellitus induces embryonic heart hypertrophy in a murine model of diabetic embryopathy...
April 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28383382/maternal-cardiovascular-mortality-in-illinois-2002-2011
#13
Joan Briller, Abigail R Koch, Stacie E Geller
OBJECTIVE: To describe the demographic characteristics of women in Illinois who died from cardiovascular disease during pregnancy or up until 1 year postpartum, addressing specific etiologies, timing of death, proportion of potentially preventable mortality, and factors associated with preventability. METHODS: This is a retrospective analysis from the Illinois Department of Public Health Maternal Mortality Review process using International Classification of Diseases, 9th Revision codes that attributed cardiovascular disease as the immediate or underlying cause of maternal death in Illinois from 2002 to 2011...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28377476/incidence-and-predictors-of-obstetric-and-fetal-complications-in-women-with-structural-heart-disease
#14
Iris M van Hagen, Jolien W Roos-Hesselink, Valentina Donvito, Csilla Liptai, Marielle Morissens, Daniel J Murphy, Laura Galian, Nooshin Mohd Bazargani, Jérôme Cornette, Roger Hall, Mark R Johnson
OBJECTIVE: Women with cardiac disease becoming pregnant have an increased risk of obstetric and fetal events. The aim of this study was to study the incidence of events, to validate the modified WHO (mWHO) risk classification and to search for event-specific predictors. METHODS: The Registry Of Pregnancy And Cardiac disease is a worldwide ongoing prospective registry that has enrolled 2742 pregnancies in women with known cardiac disease (mainly congenital and valvular disease) before pregnancy, from January 2008 up to April 2014...
April 4, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28377190/pre-pregnancy-counseling-for-women-with-heart-disease-a-prospective-study
#15
M Cauldwell, P J Steer, L Swan, R R Patel, M A Gatzoulis, A Uebing, M R Johnson
BACKGROUND: Women with cardiac disease and their infants are at a greater risk of mortality and morbidity during pregnancy. Expert groups recommend preconception counseling (PCC) for all women with cardiac disease so they are made aware of these risks. We have run a specialist maternal cardiac clinic since 1996. The aim of this study was to evaluate the experience of women who have received PCC within an established multidisciplinary tertiary clinic and to establish their views regarding the counseling they received...
March 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28371698/cardiovascular-causes-of-maternal-sudden-death-sudden-arrhythmic-death-syndrome-is-leading-cause-in-uk
#16
Dimitra Krexi, Mary N Sheppard
OBJECTIVE: This study aims to determine the causes of sudden cardiac death during pregnancy and in the postpartum period and patients' characteristics. There are few studies in the literature. METHODS: Eighty cases of sudden unexpected death due to cardiac causes in relation to pregnancy and postpartum period in a database of 4678 patients were found and examined macroscopically and microscopically. RESULTS: The mean age was 30±7 years with a range from 16 to 43 years...
May 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28343597/national-trends-and-in-hospital-outcomes-in-pregnant-women-with-heart-disease-in-the-united-states
#17
Fabio V Lima, Jie Yang, Jianjin Xu, Kathleen Stergiopoulos
Investigation of trends and outcomes in heart disease (HD) and pregnancy has been limited. We chose to identify the prevalence, trends, and outcomes of pregnant women with different forms of HD in the United States. Healthcare Cost and Utilization Project's National Inpatient Sample was screened for hospital admissions for delivery in pregnant women with HD from 2003 to 2012. Maternal clinical characteristics and outcomes were identified in women with and without HD, and in HD subtypes: congenital (CHD), valvular HD, cardiomyopathy, and pulmonary hypertension (PH)...
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28341055/obstetric-care-for-women-with-thalassemia
#18
REVIEW
Terence T Lao
Thalassemia is the commonest monogenic disease and manifests as severe anemia. It is increasingly encountered outside the Mediterranean region, Africa, Middle East, and Southeast Asia because of immigration. Pregnancy, previously uncommon in patients with homozygous β-thalassemia, is encountered increasingly because of improved management and assisted reproduction technology; however, preconceptional problems that include anemia, iron overload, cardiac dysfunction, thromboembolism, alloimmunization, infections, and endocrine and bone disorders, could influence maternal and obstetric outcome...
February 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28333321/preconception-and-early-pregnancy-maternal-haemodynamic-changes-in-healthy-women-in-relation-to-pregnancy-viability
#19
F L Foo, A Collins, C M McEniery, P R Bennett, I B Wilkinson, C C Lees
STUDY QUESTION: Are there differences in preconception cardiovascular function between women who have a viable pregnancy and those who have a first trimester miscarriage? SUMMARY ANSWER: Preconception cardiovascular function of central haemodynamics and arterial function are similar between women who have a viable pregnancy and those who have a first trimester miscarriage. WHAT IS KNOWN ALREADY: Miscarriages have been associated with increased long-term cardiovascular disease risk, and arterial and cardiovascular dysfunction has been hypothesised as the common link...
May 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28326674/whole-exome-sequencing-with-genomic-triangulation-implicates-cdh2-encoded-n-cadherin-as-a-novel-pathogenic-substrate-for-arrhythmogenic-cardiomyopathy
#20
Kari L Turkowski, David J Tester, J Martijn Bos, Kristina H Haugaa, Michael J Ackerman
BACKGROUND: Arrhythmogenic cardiomyopathy (ACM) is a heritable disease characterized by fibrofatty replacement of cardiomyocytes, has a prevalence of approximately 1 in 5000 individuals, and accounts for approximately 20% of sudden cardiac death in the young (≤35 years). ACM is most often inherited as an autosomal dominant trait with incomplete penetrance and variable expression. While mutations in several genes that encode key desmosomal proteins underlie about half of all ACM, the remainder is elusive genetically...
March 21, 2017: Congenital Heart Disease
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