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| {{Pregnancy and heart disease}}
| | #REDIRECT [[Cardiac disease in pregnancy and congenital heart disease]] |
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| {{CMG}}; '''Associate Editor-In-Chief:''' {{AC}} [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh@perfuse.org]; {{CZ}} '''Assistant Editor(s)-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@perfuse.org] {{CZ}}
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| ==Overview==
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| The most common maternal cardiac disease in Western societies is now congenital heart disease. This includes a wide spectrum of abnormalities, which are delineated in this section. This is largely due in part to the fact that children born with congenital heart defects in Western societies are living to the ages at which they can bear children. This section will not detail those patients that have repaired congenital defects, which are highlighted in the [[Pregnancy and heart disease repaired congenital heart disease|Repaired Congenital Heart Disease]] section.
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| ==[[Atrial septal defect and pregnancy|Atrial Septal Defects]]==
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| Pregnancy causes an increase in [[cardiac output]] and [[stroke volume]]. This can cause an increased [[left-to-right shunt]]ing of blood. Despite the increased workload on [[heart]], females with isolated asymptomatic [[atrial septal defect]]s tolerate the pregnancy well. Pregnant females with an atrial septal defect may have increased frequencies of some complications for instance [[arrhythmias]], [[thromboembolism]], and [[bleeding]]. Despite this, there are no studies suggesting that pregnancy requires different indications for closure in pregnant females with atrial septal defect compared to a non-pregnant female with [[atrial septal defect]]. The ACC/[[AHA]] guidelines, however, do dictate clear deviations in course of treatment in certain special circumstances. According to ACC/AHA guidelines pregnancy could be harmful in females with [[atrial septal defect]] and severe [[pulmonary hypertension]] ([[Eisenmenger syndrome]])
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| ==[[Ventricular septal defect|Ventricular Septal Defects]]==
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| Congential VSDs are collectively the most common congenital heart defect. The incidence of VSD in adulthood has decreased over past decades due to successful surgical closure of large defects.<ref>Allwork SP, Anderson RH. Developmental anatomy of the membranous part of the ventricular septum in the human heart. Br Heart J 1979; 41:275-280</ref>
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| Pregnancy in patients with VSD and severe PAH (Eisenmenger syndrome) is not recommended owing to excessive maternal and fetal mortality and should be strongly discouraged. See [[ventricular septal defect ACC/AHA guidelines |ACC/AHA guidelines]] for details.
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| ==[[Patent ductus arteriosus|Patent Ductus Arteriosus]]==
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| Generally small defects do not cause significant hemodynamic issues during pregnancy. The exception, as in other cases, is with those with pulmonary hypertension. PDAs with a very large shunt may also lead to ventricular failure in the setting of the hemodynamic changes of pregnancy.
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| ==[[Aortic coarctation|Aortic Coarctation]]==
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| Aortic coarctation is a common congenital heart defect. While statistics vary across research, aortic coarctation occurs in approximately 6-10% of all congenital heart disease cases. It often presents in pregnancy due to systemic hypertension. This can lead to small-for-dates babies and fetal loss. Most women have a successful pregnancy with coarctation but may require imaging of the aorta during prenatal care. [[Aortic coarctation treatment|Treatment options]] include medical, surgical, and catheter-based.
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| ==[[Pulmonary valve stenosis|Pulmonary Stenosis]]==
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| Generally this congenital abnormality is well tolerated if mild or repaired by surgery or valvuloplasty. It should be noted that although a woman with severe pulmonic stenosis may be asymptomatic prior to pregnancy, the hemodynamics of pregnancy can lead to right heart failure or atrial arrhythmias. Balloon valvuloplasty is feasible even during pregnancy in the setting of symptoms.<ref name="pmid11359761">{{cite journal| author=Siu SC, Colman JM| title=Heart disease and pregnancy. | journal=Heart | year= 2001 | volume= 85 | issue= 6 | pages= 710-5 | pmid=11359761 | doi= | pmc=PMC1729784 | url= }} </ref>
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| ==Congenital Aortic Stenosis==
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| ==Ebstein Anomaly==
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| ==References==
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| {{Reflist|2}}
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| [[Category:Cardiology]]
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| [[Category:Obstetrics]]
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| [[Category:Disease]]
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| {{WH}}
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| {{WS}}
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