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cardiac disease in pregnancy

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https://www.readbyqxmd.com/read/29166205/pregnant-women-with-heart-disease-placental-characteristics-and-their-association-with-fetal-adverse-events
#1
Fabio V Lima, Paraskevi Koutrolou-Sotiropoulou, Puja B Parikh, Cecilia Avila, Javed Butler, Kathleen Stergiopoulos
BACKGROUND: Pregnant women with heart disease (HD) have higher rates of adverse fetal outcomes. We describe placental pathologic characteristics and their association with fetal events. METHODS: In pregnant women, known HD were categorized into: (1) cardiomyopathy (CM) or (2) other HD (congenital, coronary, arrhythmia, or valvular). Outcomes were maternal major adverse cardiac events (MACE), fetal adverse clinical events (FACE), a composite of infant death, prematurity, underweight status, intracranial hemorrhage, and respiratory distress...
November 22, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/29164116/potential-of-metformin-to-improve-cardiac-risk-in-postpartum-women-with-gestational-diabetes
#2
Oscar A Viteri, Mary Alice Sallman, Pauline M Berens, Pamela D Berens, Farah H Amro, Maria S Hutchinson, Susan M Ramin, Sean C Blackwell, Jerrie S Refuerzo, Judith A Smith
Objective: Pregnancy is associated with an increase in total cholesterol, high density lipoproteins (HDL), and low-density lipoproteins (LDL). Postpartum, HDL and LDL decrease over the first 12 weeks postpartum. Oxidized LDL (ox-LDL) is a marker of oxidative stress-related inflammation, which is associated with obesity and also with development of cardiovascular disease. Cardiovascular protection and weight loss are benefits from metformin, especially in women with diabetes. The objective of this study was to compare changes in lipid profiles and biomarkers for obesity during the initial 6 weeks postpartum between women with gestational diabetes mellitus (GDM) treated with metformin versus placebo...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29153665/correlation-between-maternal-body-composition-and-haemodynamic-changes-in-pregnancy-different-profiles-for-different-hypertensive-disorders
#3
I Pisani, G M Tiralongo, D Lo Presti, G Gagliardi, D Farsetti, B Vasapollo, G P Novelli, A Andreoli, H Valensise
OBJECTIVES: To assess and correlate changes in body composition and haemodynamic function during pregnancy. To identify different haemodynamic profiles based on the onset of hypertensive diseases such as gestational hypertension and preeclampsia. METHODS: We enrolled 265 healthy, normotensive pregnant women throughout pregnancy (from 6+0 to 36+0weeks). They were subjected to assessment of body composition and haemodynamic function using non-invasive methods. We divided our population in three groups: group A with physiological pregnancy, group B with gestational hypertension and group C with preeclamptic patients...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29150149/pregnancy-and-heart-disease-pregnancy-associated-hypertension-and-peripartum-cardiomyopathy
#4
Tobias Jonathan Pfeffer, Denise Hilfiker-Kleiner
Cardiovascular diseases are major complications in pregnancy worldwide and the number of patients who develop cardiac problems during pregnancy is increasing. Pregnancy-associated hypertensive complications such as pre-eclampsia (PE) or peripartum cardiomyopathy (PPCM) are potentially life-threatening heart diseases emerging during pregnancy, under delivery or in the first postpartal months in previously healthy women. Both disease entities display substantial morbidity and mortality in the acute phase. Long-term effects are just beginning to be evaluated...
October 31, 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/29138200/assessing-the-consequences-of-gestational-diabetes-mellitus-on-offspring-s-cardiovascular-health-mysweetheart-cohort-study-protocol-switzerland
#5
Stefano Di Bernardo, Yvan Mivelaz, Adina Mihaela Epure, Yvan Vial, Umberto Simeoni, Pascal Bovet, Sandrine Estoppey Younes, Arnaud Chiolero, Nicole Sekarski
INTRODUCTION: Gestational diabetes mellitus (GDM) is a state of glucose intolerance with onset during pregnancy. GDM carries prenatal and perinatal risks as well as long-term risks for the mother and her child. GDM may be involved in the foetal programming of long-term cardiovascular health. However, evidence is sparse and the effect of GDM on cardiovascular health is unknown. To address these issues, we will conduct MySweetHeart Cohort study. The objectives are to assess the effect of GDM on offspring's cardiovascular health early in life by using surrogate markers of cardiovascular disease and atherosclerosis...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#6
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29111423/maternal-cardiovascular-dysfunction-in-women-with-early-onset-preeclampsia-and-late-onset-preeclampsia-a-cross-sectional-study
#7
Sindhura Vaddamani, Anish Keepanasseril, Ajith Ananthakrishna Pillai, Binay Kumar
OBJECTIVES: To compare the cardiovascular changes associated with early onset (EOPE) and late onset (LOPE) subtypes of preeclampsia. METHODS: A prospective matched cross-sectional study involving 50 women each with early and late onset subtypes of preeclampsia conducted in a tertiary hospital in South India. Cardiac function and remodelling were assessed by conventional 2D, M-mode and doppler echocardiography. RESULTS: Women with EOPE had a significantly more altered left ventricular (LV) geometry, global LV diastolic dysfunction, impairment in myocardial contractility (40% vs...
October 25, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29102503/maternal-hemodynamics-a-method-to-classify-hypertensive-disorders-of-pregnancy
#8
Enrico Ferrazzi, Tamara Stampalija, Lorenzo Monasta, Daniela Di Martino, Sharona Vonck, Wilfried Gyselaers
BACKGROUND: The classification of hypertensive disorders of pregnancy is based on the time at the onset of hypertension, proteinuria, and other associated complications. Maternal hemodynamic interrogation in hypertensive disorders of pregnancy considers not only the peripheral blood pressure but also the entire cardiovascular system, and it might help to classify the different clinical phenotypes of this syndrome. OBJECTIVE: This study aimed to examine cardiovascular parameters in a cohort of patients affected by hypertensive disorders of pregnancy according to the clinical phenotypes that prioritize fetoplacental characteristics and not the time at onset of hypertensive disorders of pregnancy...
November 2, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29101986/acr-appropriateness-criteria-%C3%A2-multiple-gestations
#9
Phyllis Glanc, David A Nyberg, Nadia J Khati, Sandeep Prakash Deshmukh, Kika M Dudiak, Tara Lynn Henrichsen, Liina Poder, Thomas D Shipp, Lynn Simpson, Therese M Weber, Carolyn M Zelop
Women with twin or higher-order pregnancies will typically have more ultrasound examinations than women with a singleton pregnancy. Most women will have at minimum a first trimester scan, a nuchal translucency evaluation scan, fetal anatomy scan at 18 to 22 weeks, and one or more scans in the third trimester to evaluate growth. Multiple gestations are at higher risk for preterm delivery, congenital anomalies, fetal growth restriction, placenta previa, vasa previa, and velamentous cord insertion. Chorionicity and amnionicity should be determined as early as possible when a twin pregnancy is identified to permit triage of the monochorionic group into a closer surveillance model...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29094357/systematic-review-and-meta-analysis-of-the-performance-of-second-trimester-screening-for-prenatal-detection-of-congenital-heart-defects
#10
Christine L van Velzen, Johannes C F Ket, Peter M van de Ven, Nico A Blom, Monique C Haak
BACKGROUND: The prenatal detection rate of congenital heart defects (CHDs) is increasing, but reported rates vary. OBJECTIVE: To determine the performance of the second-trimester anomaly scan to detect CHD. SEARCH STRATEGY: PubMed and Embase were searched for relevant studies in any language from inception to February 3, 2017. The search terms included "prenatal diagnosis" or "pregnancy," "cardiovascular diseases" or "cardiac defects," "congenital," and "specificity," or "sensitivity," or "cohort study...
November 2, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29092914/influence-of-socioeconomic-factors-on-pregnancy-outcome-in-women-with-structural-heart-disease
#11
Iris M van Hagen, Sara Baart, Rebekah Fong Soe Khioe, Karen Sliwa-Hahnle, Nasser Taha, Malgorzata Lelonek, Luigi Tavazzi, Aldo Pietro Maggioni, Mark R Johnson, Nikolaos Maniadakis, Richard Fordham, Roger Hall, Jolien W Roos-Hesselink
OBJECTIVE: Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease. METHODS: The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29089251/longitudinal-study-to-assess-changes-in-arterial-stiffness-and-cardiac-output-parameters-among-low-risk-pregnant-women
#12
Mohamed Waseem Osman, Mintu Nath, Asma Khalil, David R Webb, Thompson G Robinson, Hatem A Mousa
AIM: A single-centre, prospective longitudinal study to assess changes in maternal arterial stiffness and cardiac output parameters among low-risk healthy pregnant women. METHODOLOGY: Thirty low-risk, healthy, pregnant women attending their routine antenatal dating ultrasound scan were recruited. Non-invasive assessment of arterial stiffness and cardiac output was undertaken at five gestational windows from 11 to 40 weeks of pregnancy. Data were analysed using a linear mixed model incorporating time and other relevant predictors as fixed effects, and patient as a random effect...
October 16, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29069030/clinical-outcomes-of-peripartum-cardiomyopathy-a-15-year-nationwide-population-based-study-in-asia
#13
Victor Chien-Chia Wu, Tien-Hsing Chen, Jih-Kai Yeh, Michael Wu, Cheng-Hui Lu, Shao-Wei Chen, Katie Pei-Hsuan Wu, Chun-Wen Cheng, Chih-Hsiang Chang, Kuo-Chun Hung, Ming-Shyan Chern, Fen-Chiung Lin, Ming-Shien Wen
Peripartum cardiomyopathy (PPCM) is the development of heart failure during late pregnancy to months postpartum with potential fatal outcome. However, the disease is not well-studied in Asia.We aimed to investigate the epidemiology and clinical outcomes of PPCM in Taiwan.Electronic medical records were retrieved from Taiwan National Health Insurance Research Database from 1997 to 2011. Patients with PPCM were separated into 3 groups based on the timing of diagnosis. Early: PPCM diagnosed first to ninth month of pregnancy...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29066439/pulmonary-hypertension-and-pregnancy-outcomes-insights-from-the-national-inpatient-sample
#14
Erin Thomas, Jie Yang, Jianjin Xu, Fabio V Lima, Kathleen Stergiopoulos
BACKGROUND: Pregnant women with pulmonary hypertension (PH) are at risk for adverse cardiac outcomes, particularly at the time of labor and delivery. The purpose of this study is to define the impact of PH on pregnancy outcomes and the risk of major adverse cardiac events (MACE). METHODS AND RESULTS: The National Inpatient Sample was screened for hospital admissions of women delivering during the years 2003 to 2012. The primary outcome was MACE, a composite of death, cardiac arrest, cardiogenic shock, myocardial infarction, respiratory failure, arrhythmia, stroke, and embolic event...
October 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29051776/fontan-circulation-and-implications-for-future-reproduction
#15
REVIEW
Niharika Mehta, Srilakshmi Mitta
This article summarizes and critiques four recent publications looking at preconception counseling, pregnancy outcomes, and cardiac complications in women with history of Fontan circulation. The Fontan procedure is a palliative strategy for single-ventricle type congenital heart disease and involves passive flow of venous return into the pulmonary circulation, bypassing the ventricles. Pregnancy in these patients is not without risk and preconception counseling and contraception practices vary widely. High rates of miscarriage, prematurity, and small-for-gestational-age babies are reported...
September 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29045977/-clinical-and-genetic-characteristics-of-williams-beuren-syndrome-2-cases-report
#16
S Q Wang, Z X Yang, H Li
To explore the clinical and genetic characteristics of Williams-Beuren syndrome (WBS) and to raise awareness of the disease. The characteristics of clinical manifestations, personal history, cardiac ultrasound, brain magnetic resonance imaging (MRI), electroencephalogram (EEG) and chromosome detection results of two cases with WBS were analyzed. The two patients were both male and the age was 11 months and 1 day, and 9 months and 9 days, respectively. They both suffered from cardiovascular malformation: case one presented supravalvular aortic stenosis, and case two showed atrial septal defect and patent ductus arteriosus...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29033728/anesthesia-in-pregnancy-with-heart-disease
#17
REVIEW
Ankur Luthra, Ritika Bajaj, Anudeep Jafra, Kiran Jangra, V K Arya
Management of pregnant women with heart disease remains challenging due to the advancement of innovations in cardiac surgery and correction of complex cardiac anomalies, and more recently, with the successful performance of heart transplants, cardiac diseases are not only likely to coexist with pregnancy, but will also increase in frequency over the years to come. In developing countries with a higher prevalence of rheumatic fever, cardiac disease may complicate as many as 5.9% of pregnancies with a high incidence of maternal death...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28979861/treatment-of-dermatophytosis-in-elderly-children-and-pregnant-women
#18
REVIEW
Subuhi Kaul, Savita Yadav, Sunil Dogra
Dermatophytic infection of the skin and its appendages is a common occurrence. Though usually straightforward, treatment of dermatophytosis becomes notably challenging in certain population groups - pregnant women, children, and elderly. Treatment with topical azoles/allylamines alone is effective in limited cutaneous disease in all three groups. Terbinafine is the preferred oral agent in elderly population for treatment of extensive cutaneous disease and onychomycosis due to its lack of cardiac complications and lower propensity for drug interactions...
September 2017: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/28976408/real-world-safety-and-patient-profile-of-fingolimod-in-relapsing-remitting-multiple-sclerosis-a-prospective-analysis-in-buenos-aires-argentina
#19
Juan Ignacio Rojas, Liliana Patrucco, Jimena Miguez, Edgardo Cristiano
OBJECTIVE: The aim was to evaluate fingolimod safety and patient profiles in a real-world setting in Buenos Aires, Argentina. METHODS: Relapsing-remitting patients with multiple sclerosis who had been prescribed fingolimod and at least 18 months or more of follow-up were included. Demographic, clinical, and safety issues were described during first dose and follow-up. RESULTS: A total of 145 patients were included, 68% female; mean age, 30 ± 10...
November 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28966042/pregnancy-in-women-with-corrected-aortic-coarctation-uteroplacental-doppler-flow-and-pregnancy-outcome
#20
Anne S Siegmund, Marlies A M Kampman, Caterina M Bilardo, Ali Balci, Arie P J van Dijk, Martijn A Oudijk, Barbara J M Mulder, Jolien W Roos-Hesselink, Gertjan Tj Sieswerda, Steven V Koenen, Krystyna M Sollie-Szarynska, Tjark Ebels, Dirk J van Veldhuisen, Petronella G Pieper
OBJECTIVE: Women with repaired coarctation of the aorta (rCoA) are at risk of hypertensive disorders and other complications during pregnancy. Hypertensive disorders in pregnant women are associated with inadequate uteroplacental flow, which is related to adverse offspring outcome. The aim of this study was to investigate the relationship of maternal cardiac function, placental function and pregnancy complications in women with rCoA. METHODS: We included 49 pregnant women with rCoA and 69 controls from the prospective ZAHARA-studies (Zwangerschap bij Aangeboren HARtAfwijkingen, pregnancy in congenital heart disease)...
December 15, 2017: International Journal of Cardiology
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