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Maternal Cardiac Disease

D Stott, M Bolten, D Paraschiv, I Papastefanou, J B Chambers, N A Kametas
OBJECTIVE: Pregnant hypertensive women who do not respond to labetalol but need vasodilatory therapy for blood pressure (BP) control rapidly progress to severe disease, which may be delayed by early recognition and individualised BP treatment. In this study, we sought to create prediction models at presentation, at 1 and 24 hours after commencement of treatment to identify patients who will not show a sustained response to labetalol and therefore need vasodilatory therapy. METHODS: The study population comprised of 134 women presenting with hypertension at a UK hospital...
October 20, 2016: Ultrasound in Obstetrics & Gynecology
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Elisabeth Leirgul, Kristoffer Brodwall, Gottfried Greve, Stein E Vollset, Henrik Holmstrøm, Grethe S Tell, Nina Øyen
OBJECTIVE: To investigate the association between pregestational or gestational diabetes and offspring risk of congenital heart defects and the association between large-for-gestational-age birth weight and risk of cardiac defects in offspring of diabetic women. METHODS: Information on pregestational and gestational diabetes, cardiac defects, and birth weight among all births in Norway in 1994-2009 was ascertained from the Medical Birth Registry of Norway, national health registries, and the Cardiovascular Disease in Norway project...
October 6, 2016: Obstetrics and Gynecology
Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
Rohan D'Souza, Candice K Silversides, Claire McLintock
The prothrombotic state of pregnancy increases the risk of thromboembolic complications and death in women with mechanical heart valves (MHVs). Although it is accepted that these women must be on therapeutic anticoagulation throughout pregnancy, competing maternal and fetal risks, as well as the lack of high-quality data from prospective studies, make the choice of the optimal method of anticoagulation challenging. Vitamin K antagonists (VKAs) are associated with fewer maternal complications, but conversely also the lowest live birth rates as well as warfarin-related embryopathy and fetopathy...
October 5, 2016: Seminars in Thrombosis and Hemostasis
D Farsetti, D Lo Presti, I Pisani, G M Tiralongo, G Gagliardi, B Vasapollo, G P Novelli, H Valensise
INTRODUCTION: The purpose of our study was to evaluate the maternal haemodynamic profile in women diagnosed with threatened preterm delivery (TPD) in order to understand the possible pathophysiologic mechanism leading to an increased lifetime risk for future cardiovascular disease. METHODS: Sixty-eight patients diagnosed with TPD were enrolled and assessed using a non-invasive method (USCOM®) to determine the haemodynamic parameters. Cervix length assessment, vaginal and rectal swabs, blood inflammatory indexes, foetal vessel Doppler velocimetry, gestational age at the delivery and neonatal outcomes were considered...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Meryem Kurek Eken, Abdülhamit Tüten, Enis Özkaya, Güner Karatekin, Ateş Karateke
OBJECTIVE: To assess the predictors of outcome in terms of length of stay in the neonatal intensive care unit (NICU) and survival of neonates from women with preterm premature rupture of membranes (PPROM). METHODS: A population-based retrospective study including three hundred thirty-one singleton pregnant women with PPROM at 24-34 gestational weeks between January 2013 and December 2015 was conducted. Gestational age at delivery, birth weight, route of delivery, newborn gender, maternal age,oligohydramnios, premature retinopathy (ROP), necrotising enterocolitis (NEC), sepsis, fetal growth retardation (FGR), intracranial hemorrhagia (ICH), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), primary pulmonary hypertension (PPH), congenital cardiac disease (CCD), patent ductus arteriosus (PDA), use of cortisol (betamethasone) and maternal complications including gestational diabetes, preeclampsia, and chorioamnionitis were used to predict neonatal outcomes in terms of length of stay in the NICU and survival...
September 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
Fiona J Stewart, Andrew Bentley, Barbara K Burton, Nathalie Guffon, Susan L Hale, Paul R Harmatz, Susanne G Kircher, Pavan K Kochhar, John J Mitchell, Ursula Plöckinger, Sue Graham, Stephen Sande, Zlatko Sisic, Tracey A Johnston
The mucopolysaccharidoses (MPS disorders) are rare inherited diseases associated with multi-organ accumulation of glycosaminoglycans, leading to musculoskeletal, respiratory, cardiac, neurological, ophthalmological, otolaryngological, and gastrointestinal abnormalities. As a result of improvements in diagnosis, multi-disciplinary care, and therapies such as enzyme replacement therapy and hematopoietic stem cell transplantation, an increasing number of patients with MPS are reaching adulthood and are involved in family planning...
September 2016: Molecular Genetics and Metabolism Reports
Lisheng Yang, Qunying Mao, Shuxuan Li, Fan Gao, Huan Zhao, Yajing Liu, Junkai Wan, Xiangzhong Ye, Ningshao Xia, Tong Cheng, Zhenglun Liang
Coxsackievirus A6 (CA6) can induce atypical hand, foot, and mouth disease, which is characterized by severe rash, onychomadesis and a higher rate of infection in adults. Increasing epidemiological data indicated that outbreaks of CA6-associated hand, foot, and mouth disease have markedly increased worldwide in recent years. However, the current body of knowledge on the infection, pathogenic mechanism, and immunogenicity of CA6 is still very limited. In this study, we established the first neonatal mouse model for the evaluation of antibodies and vaccines against CA6...
October 2016: Antiviral Research
Jihene Methlouthi, Nabiha Mahdhaoui, Manel Bellaleh, Aida Guith, Douha Zouari, Hedia Ayech, Sonia Nouri, Hassen Séboui
INTRODUCTION: Congenital heart defects are the most common congenital malformations in the newborn with an estimated incidence ranging between 6-9 ‰. In Tunisia, this incidence reaches 1.9 ‰. This can be explained by misdiagnosed cases. In fact, the diagnosis is based mainly on clinical examination which allows making the diagnosis only in 50 in 75 % of the cases. Several studies showed the interest of pulse oximetry oximeter in the screening of cyanogenic and duct dependent congenital heart diseases...
March 2016: La Tunisie Médicale
Nelli Perkiömäki, Juha Auvinen, Mikko P Tulppo, Arto J Hautala, Juha Perkiömäki, Ville Karhunen, Sirkka Keinänen-Kiukaanniemi, Katri Puukka, Aimo Ruokonen, Marjo-Riitta Järvelin, Heikki V Huikuri, Antti M Kiviniemi
BACKGROUND: Low birth weight is associated with an increased risk of cardiovascular diseases in adulthood. As abnormal cardiac autonomic function is a common feature in cardiovascular diseases, we tested the hypothesis that low birth weight may also be associated with poorer cardiac autonomic function in middle-aged subjects. METHODS: At the age of 46, the subjects of the Northern Finland Birth Cohort 1966 were invited to examinations including questionnaires about health status and life style and measurement of vagally-mediated heart rate variability (rMSSD) from R-R intervals (RRi) and spontaneous baroreflex sensitivity (BRS) in both seated and standing positions...
2016: PloS One
Lakha Prasannan, Matthew J Blitz, Jill M Rabin
INTRODUCTION: Acute myocardial infarction (MI) in pregnancy is a rare event, usually occurring late in gestation, either in the third trimester or in the puerperium. It is associated with significant maternal and fetal morbidity and mortality. Although diagnosis and management of MI in pregnancy has been discussed in the literature, management of pregnancy following an early antepartum MI, which may have more consequences for the fetus, has not received as much attention. CASE: A 38-year-old great grand multiparous woman presented to the emergency department complaining of acute onset chest pain...
July 2016: American Journal of Perinatology Reports
Matthew Cauldwell, Kate Von Klemperer, Anselm Uebing, Lorna Swan, Philip J Steer, Michael Gatzoulis, Mark R Johnson
OBJECTIVE: To examine the duration of the passive and active parts of the second stage (SS) of labour in women with cardiac disease (CD) and to assess the adherence to antenatal care plans regarding timing of assisted delivery. Cardiac parameters were measured in a subset of women to investigate any differences between the passive and active SS of labour. STUDY DESIGN: Cohort study of 73 women with CD, classified into mWHO Class Groups I-IV. Women were matched with an equal number of women controlling for gestational age, maternal age (+/- five years), parity, use of regional anaesthesia, and spontaneous versus assisted delivery...
November 1, 2016: International Journal of Cardiology
Narasimhan Chitra, I B Vijayalakshmi
BACKGROUND: Fetal echocardiography is a complete two-dimensional and Doppler ultrasound evaluation of the human fetal cardiovascular system. It is completely noninvasive, harmless, and also serves as the fetal electrocardiogram. AIM: To analyze the fetal echocardiographic cases referred to a tertiary cardiac center. MATERIALS, METHODS, AND RESULTS: A total of 478 cases of fetal echocardiograms performed over a period of 5.5 years were compiled and analyzed...
August 16, 2016: Journal of Echocardiography
Magalie Ladouceur, Louise Benoit, Jelena Radojevic, Adeline Basquin, Claire Dauphin, Sébastien Hascoet, Pamela Moceri, Charlene Bredy, Laurence Iserin, Marielle Gouton, Jacky Nizard
OBJECTIVE: There is growing evidence that maternal mortality in pregnant women with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD) is lower than that in available data. In order to evaluate this hypothesis, we collected data of pregnancies in women with PAH-CHD. METHODS: Women with PAH-CHD followed in seven French referral centres were retrospectively included from 1997 to 2015. All pregnancies were recorded. We collected data on maternal, obstetrical and neonatal outcomes...
August 10, 2016: Heart: Official Journal of the British Cardiac Society
Rohan Bhatia, Nidhi Kaeley, Ruby Bhatia
Pregnancy with pulmonary hypertension - WHO risk class IV cardiac disease is associated with significant haemodynamic burden due to cardiocirculatory changes which is a significant indirect cause of maternal mortality. We report a very rare case - primigravida term pregnancy with pulmonary hypertension, large ventricular septal defect (2.4 cm(2)), bidirectional shunt mainly left to right with severe pulmonary stenosis with peak gradient of 144mmHg. Caesarean section was done under general anaesthesia with successful maternal and neonatal outcome...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
María Perales, Alejandro Santos-Lozano, Fabian Sanchis-Gomar, María Luaces, Helios Pareja-Galeano, Nuria Garatachea, Rubén Barakat, Alejandro Lucia
BACKGROUND: Scarce evidence is available on the potential cardiovascular abnormalities associated with some common gestational complications. We aimed to analyze the potential maternal cardiac alterations related to gestational complications, including body mass index (BMI) >25 kg/m(2), gaining excessive weight, or developing antenatal depression. METHODS: The design of this study was a secondary analysis of a randomized controlled trial. Echocardiography was performed to assess cardiovascular indicators of maternal hemodynamic, cardiac remodeling and left ventricular (LV) function in 59 sedentary pregnant women at 20 and 34 weeks of gestation...
July 2016: Annals of Translational Medicine
Shuang Liu, Uri Elkayam, Tasneem Z Naqvi
Cardiovascular disease (CVD) remains the leading cause of maternal mortality, and clinical diagnosis of CVD in women during pregnancy is challenging. Pregnant women with known heart disease require careful multidisciplinary management by obstetric and medical teams to assess for maternal and fetal risk. Echocardiography is a safe and effective diagnostic tool indicated in pregnant women with cardiac symptoms or women with known cardiac disease for appropriate selection of women who require close monitoring of cardiac condition and valvular function...
September 2016: Current Cardiology Reports
Meena Narayanan, Uri Elkayam, Tasneem Z Naqvi
The prevalence of pregnant women with cardiovascular heart disease is increasing. Transthoracic echocardiography is safe during pregnancy, and it is an important diagnostic tool in pregnant women with established heart disease in order to monitor ventricular and valvular anatomy and function. In addition, it can be used to delineate cardiac anatomy in complex congenital heart disease and help stratify maternal risk during pregnancy. This review will focus on the use of echocardiography in the diagnosis and management of pregnant women with common congenital lesions and with prosthetic valves...
September 2016: Current Cardiology Reports
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