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https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#1
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28623036/-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-literature-review-and-case-report
#2
William Alejandro Camargo-Ariza, Silvia Juliana Galvis-Blanco, Tatiana Del Pilar Camacho-Enciso, Carlos Alberto Quiroz-Romero, Juan José Bermudez-Echeverry
Arrhythmogenic right ventricular cardiomyopathy/dysplasia is an inherited autosomal dominant pathology with an estimated prevalence of 1:2,500 to 1:5,000, being higher in males (3:1). It is characterized histologically by replacement of cardiomyocytes by fibro-adipose tissue, which predisposes to ventricular arrhythmias, right ventricular failure, and sudden cardiac death. The main goal of treatment is to reduce the risk of sudden death and improve the quality of life of patients. We present the case of a 23 year old woman whose clinical symptoms started with palpitations, chest pain with physical activity, syncope and headache 6 years ago during her first pregnancy...
June 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28622145/clinical-analyses-of-383-cases-with-maternal-cardiac-diseases
#3
Emine Aydin, Ozgur Ozyuncu, Dila Kasapoglu, Gokcen Orgul, Necla Ozer, Murat Yurdakok, M Sinan Beksac
AIM: To evaluate the pregnancy outcomes of women with heart disease. MATERIALS AND METHODS: In this retrospective study, 383 pregnant women with cardiac diseases were examined. The cases were classified according to the World Health Organization (WHO) classification. The distribution of the cases according to class, congenital heart diseases, mean birthweight, mean gestational week at delivery, type of delivery [cesarean section (CS) or vaginal delivery], and cardivascular events (during pregnancy and puerperium) were evaluated...
June 5, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28617685/adult-congenital-heart-disease-magnitude-of-the-problem
#4
Akanksha N Thakkar, Ponraj Chinnadurai, C Huie Lin
PURPOSE OF REVIEW: To define the magnitude of problems faced by patients with adult congenital heart disease (ACHD) and to identify unmet needs for this population. RECENT FINDINGS: The ACHD population is estimated to include more than 1 million people in the United States and continues to grow at a steady rate. Owing to the decline in early mortality in this group, modern medicine is now faced by the long-term complications associated with congenital heart disease such as chronic heart failure, increased endocarditis risk, elevated burden of arrhythmias, pulmonary hypertension, valvular dysfunction, and pregnancy...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28611934/etiology-and-perinatal-outcome-of-nonimmune-hydrops-fetalis-in-southern-china
#5
Sheng He, Linlin Wang, Pingshan Pan, Hongwei Wei, Dahua Meng, Juan Du, Xiaoxian Tian, Chenguang Zheng, Xiaoxia Qiu, Guoyang Luo
Objective  This study aims to analyze the etiology and perinatal outcome of nonimmune hydrops fetalis (NIHF) in Southern China. Methods  All cases with NIHF diagnosed antenatally from January 1, 2007 to December 31, 2014 were identified and analyzed. Results  Total 482 cases of NIHF were identified during the study period. The most common cause of NIHF was hemoglobin (Hb) Bart's disease (61.8%), followed by chromosomal abnormalities (13.5%), idiopathic etiology (13.1%), cardiac abnormalities (6.4%), and others (5...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28583776/-neonatal-hyperthyroidism-a-sometimes-challenging-diagnosis
#6
C Couturier, F Cneude, A Spiteri, F Nugues, T Debillon
Graves disease complicates two pregnancies out of 1000 and when it is known before pregnancy, it warrants careful monitoring of the fetus and the newborn. We report on a case of neonatal hyperthyroidism, which revealed a previously unknown maternal thyroid disease. In this situation, neonatal signs can be misinterpreted, delaying the diagnosis. Neonatal hyperthyroidism is, however, a therapeutic emergency because of the risk of cardiac and neurological complications. The neonatologist must identify thyroid disease in the absence of a maternal history in order to promptly start therapy...
July 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28578168/neonatal-outcomes-in-fetuses-with-cardiac-anomalies-and-the-impact-of-delivery-route
#7
Laura I Parikh, Katherine L Grantz, Sara N Iqbal, Chun-Chih Huang, Helain J Landy, Melissa H Fries, Uma M Reddy
BACKGROUND: Congenital fetal cardiac anomalies compromise the most common group of fetal structural anomalies. Several previous reports analyzed all types of fetal cardiac anomalies together without individualized neonatal morbidity outcomes based on cardiac defect. Mode of delivery in cases of fetal cardiac anomalies varies greatly as optimal mode of delivery in these complex cases is unknown. OBJECTIVE: We sought to determine rates of neonatal outcomes for fetal cardiac anomalies and examine the role of attempted route of delivery on neonatal morbidity...
May 31, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28574808/fetal-cardiac-us-techniques-and-normal-anatomy-correlated-with-adult-ct-and-mr-imaging
#8
Neel Patel, Evan Narasimhan, Anne Kennedy
Congenital heart disease (CHD) is an important cause of childhood mortality. Despite the widespread use of ultrasonography (US) as a screening tool, the prenatal detection rate is suboptimal. Improvement of the initial screening examination, which is performed in low-risk populations and often interpreted by community radiologists, targets a point in the screening process that is likely to have the largest population effect. If the goal of community-based screenings is to detect cases that may be abnormal and refer those to specialized centers for complete assessment, it is logical to use a checklist to confirm normal anatomy...
June 2, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28571229/role-of-echocardiography-in-prenatal-screening-of-congenital-heart-diseases-and-its-correlation-with-postnatal-outcome
#9
Shivani Sharma, Navkiran Kaur, Khushpreet Kaur, Naveen Chandrashekhar Pawar
INTRODUCTION: Congenital Heart Defects (CHDs) are one of the most common forms of congenital anomalies. Fetal echocardiography performed during second trimester aims at early diagnosis of congenital heart disease which is instrumental in proper planning of delivery, perinatal care and counselling of parents. AIM: To evaluate the role of fetal echocardiography in prenatal screening of CHDs and to study the role of associated extracardiac anomalies. MATERIALS AND METHODS: This was a hospital based prospective and correlative type of study, done over a period of one year...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28557250/decreased-endothelial-function-and-increased-subclinical-heart-failure-in-women-many-years-after-pre-eclampsia
#10
N M Breetveld, C Ghossein-Doha, J van Neer, M J J M Sengers, L Geerts, S M J van Kuijk, A P van Dijk, M J van der Vlugt, W M Heidema, H P Brunner-La Rocca, R R Scholten, M E A Spaanderman
OBJECTIVES: Pre-eclampsia (PE) is associated with both postpartum endothelial dysfunction and asymptomatic structural heart alterations consistent with heart failure stage B (HF-B). In this study we assessed the relation between endothelial function, by means of flow-mediated dilation (FMD), and HF-B at 4 years postpartum. METHODS: In 67 formerly PE women and 37 healthy parous controls, we ultrasonographically assessed cardiac function, geometry and FMD. HF-B was diagnosed as left ventricular hypertrophy (left ventricular mass index (LVMi) >95 g/m(2) ), concentric remodelling (relative wall thickness (RWT) >0...
May 27, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28552468/air-pollution-and-cardiovascular-events-at-labor-and-delivery-a-case-crossover-analysis
#11
Sandie Ha, Tuija Männistö, Danping Liu, Seth Sherman, Qi Ying, Pauline Mendola
PURPOSE: In this case-crossover study, we investigated the odds of having a labor/delivery with cardiovascular event (i.e., ischemic heart disease, stroke, heart failure, cardiac arrest/failure, and other or unspecified cardiovascular events) associated with acute exposure to common air pollutants. METHODS: We selected 680 women with singleton pregnancy and cardiovascular events at labor/delivery from 12 U.S. clinical sites (2002-2008). Exposures to six criteria air pollutants, six particulate constituents, and 26 air toxics were obtained using modified Community Multiscale Air Quality models...
May 12, 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28551920/-women-s-cardiac-health-from-theory-to-activism
#12
REVIEW
Avital Porter
Cardiovascular disease (CVD) is the leading cause of death in the western world, in both genders. Although awareness of the importance of prevention, diagnosis and optimal treatment of CVD has risen in general, most women are not fully aware of their CVD risk. Moreover, women are not alert to the burden of risk in their reproductive years (e.g. complicated pregnancy and/or peri-menopausal period) and their impact on future CVD. Unique Female issues such as: fertile age, menopause, oral contraceptives, hormonal and metabolic disorders during pregnancy, labor, as well as psychological matters, and healthy life-style are major contributors to primary and secondary prevention of CVD...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28545637/preterm-birth-and-risk-of-heart-failure-up%C3%A2-to-early-adulthood
#13
Hanna Carr, Sven Cnattingius, Fredrik Granath, Jonas F Ludvigsson, Anna-Karin Edstedt Bonamy
BACKGROUND: In small clinical studies, preterm birth was associated with altered cardiac structure and increased cardiovascular mortality in the young. OBJECTIVES: The goal of this study was to determine the association between preterm birth and risk of incident heart failure (HF) in children and young adults. METHODS: This register-based cohort study included 2,665,542 individuals born in Sweden from 1987 to 2012 who were followed up from 1 year of age to December 31, 2013...
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28539207/effect-of-maternal-age-and-cardiac-disease-severity-on-outcome-of-pregnancy-in-women-with-congenital-heart-disease
#14
Eva Furenäs, Peter Eriksson, Ulla-Britt Wennerholm, Mikael Dellborg
BACKGROUND: There is an increasing prevalence of women with congenital heart defects reaching childbearing age. In western countries women tend to give birth at a higher age compared to some decades ago. We evaluated the CARdiac disease in PREGnancy (CARPREG) and modified World Health Organization (mWHO) risk classifications for cardiac complications during pregnancies in women with congenital heart defects and analyzed the impact of age on risk of obstetric and fetal outcome. METHODS: A single-center observational study of cardiac, obstetric, and neonatal complications with data from cardiac and obstetric records of pregnancies in women with congenital heart disease...
May 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28525397/an-unusual-case-of-sudden-death-is-there-a-relationship-between-thyroid-disorders-and-fatal-pulmonary-thromboembolism-a-case-report-and-review-of-literature
#15
Isabella Aquila, Silvia Boca, Fiorella Caputo, Matteo A Sacco, Santo Gratteri, Vittorio Fineschi, Pietrantonio Ricci
In adults, the most common cause of sudden death is coronary heart disease or defects in the cardiac conduction system; however, there are many cases of sudden death occurring from other causes such as fatal pulmonary thromboembolism. Several risk factors are recognized, including hospitalization, surgery, obesity, pregnancy, the use of oral contraceptives, traumatic fractures, and genetic conditions, which cause hypercoagulable states such as factor V Leiden mutations. Although many risk factors have been identified, the mortality rate is still high...
May 19, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28523440/assessing-and-modifying-coronary-artery-disease-risk-in-women
#16
REVIEW
Amy Sarma, Nandita S Scott
Despite continued advances in the field, cardiovascular disease remains the leading cause of death in women in the USA with an annual mortality rate that has remained higher for women as compared to men. The factors leading to this sex difference remain incompletely understood. Likely contributors include atypical symptoms at presentation and lack of recognition of cardiovascular risk by women and their providers alike. In addition, women have a higher burden of comorbidities at the time of disease diagnosis and can have differential pathophysiological mechanisms of their acute events...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28516275/the-role-of-cardiac-biomarkers-in-pregnancy
#17
REVIEW
Emily S Lau, Amy Sarma
Cardiovascular disease (CVD) is the leading cause of pregnancy-associated mortality, with an increasingly complex pregnant population. While our understanding of CVD in pregnancy continues to evolve, there remains a need to develop widely accessible tools to follow pregnant women both with and without preexisting disease with respect to cardiovascular risk, particularly for those presenting with symptoms suggestive of cardiovascular pathology. Thus, research is emerging with respect to the potential role of novel and established cardiac biomarkers in diagnosing and following CVD in pregnancy...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28511860/first-trimester-fetal-echocardiography-identification-of-cardiac-structures-for-screening-from-6-to-13%C3%A2-weeks-gestational-age
#18
Darren Hutchinson, Angela McBrien, Lisa Howley, Yuka Yamamoto, Priya Sekar, Tarek Motan, Venu Jain, Winnie Savard, Lisa K Hornberger
BACKGROUND: Early fetal echocardiography (FE), performed at 12 to 16 weeks' gestational age (GA), can be used to screen for fetal heart disease akin to that routinely performed in the second trimester. The efficacy of FE at earlier GAs has not been as well explored, particularly with recent advances in ultrasound technology. The aim of this study was to evaluate the efficacy of early FE in assessing fetal heart structure, and the added benefit of color Doppler (CD), from as early as 6 weeks through to 13(+6) weeks' GA...
May 13, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28511453/pregnancy-outcome-of-abnormal-nuchal-translucency-a-systematic-review
#19
Nasibeh Roozbeh, Maryam Azizi, Leili Darvish
INTRODUCTION: Nuchal Translucency (NT) is the sonographic form of subcutaneous gathering of liquid behind the foetal neck in the first trimester of pregnancy. There is association of increased NT with chromosomal and non-chromosomal abnormalities. AIM: The purpose of this systemic review was to review the pregnancy outcome of abnormal nuchal translucency. MATERIALS AND METHODS: The present systematic review was conducted by searching English language articles from sources such as International Medical Sciences, Medline, Web of science, Scopus, Google Scholar, PubMed, Index Copernicus, DOAJ, EBSCO-CINAHL...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28498066/atrial-fibrillation-in-pregnancy-a-growing-challenge
#20
Vasiliki Katsi, Georgios Georgiopoulos, Maria Marketou, Dimitrios Oikonomou, Fragiskos Parthenakis, Thomas Makris, Petros Nihoyannopoulos, P Vardas, Dimitris Tousoulis
BACKGROUND: 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...
June 8, 2017: Current Medical Research and Opinion
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