[Heart diseases in pregnant women].

BACKGROUND: diagnosis end treatment of heart diseases, physiopathologic changes in pregnancy.

AIM: Pregnancy in woman with heart disease increases the risk of maternal and fetal complications. The aim of the study is to precise the physiopathologic, diagnostic, and therapeutic characteristics of heart diseases in pregnant woman.

METHODS: Extensive electronic search of the relevant literature was carried out using Medline. Key words used were:pregnancy, heart disease, maternal outcome, fetal outcome, cardiac complications.

RESULTS: Rheumatic heart disease represent the most common cardiopathy found in pregnant woman in our country. Regurgitant valvular diseases are often well tolerated with medical therapy. Severe aortic stenosis is associated with poor prognosis. The use of percutaneous mitral balloon valvuloplasty has transformed treatment of mitral stenosis in symptomatic patients.In developed countries, congenital heart diseases are the most common cause of cardiopathy in pregnant women. Left-to-right shunts are generally well tolerated. Patients with Eisenmenger syndrome should be advised against pregnancy. Obstructive form of hypertrophic cardiomyopathy is associated frequently with hemodynamic deterioration in pregnancy. Dilated cardiomyopathy is usually considered as a contraindication of pregnancy. In the absence of underlying structural heart disease, cardiac arrhythmia are uncommon in pregnancy and usually don't require pharmacological treatment. Drug therapy of arrhythmia in pregnant woman is limited by side effects on the fetus. The prenatal counsel is based on the assessment of maternofetal risk. The management of pregnant woman requires a multidisciplinary team for optimal maternal and fetal outcomes.