Practical assessment of maternal cardiovascular risk in pregnancy

Nazanin Moghbeli, Emmanuelle Pare, Gary Webb

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Cardiovascular disease in pregnancy is the most common cause of maternal mortality in the developed world and an important cause of heart failure, stroke, and arrhythmia. As more children with congenital heart disease survive into adulthood, there is a more pressing need to understand the risks that pregnancy poses for these women. Pregnancy, labor, and delivery increase the hemodynamic stress on the cardiovascular system and place women with heart disease at increased risk of cardiovascular complications, which include heart failure and death. Systematic assessment of pregnancy risk in these women, ideally before conception, is essential in optimizing maternal and fetal outcomes. This article describes the process of assessing risk of pregnancy-associated cardiovascular complications in women with structural heart disease. We review the current literature on pregnancy risk in women with complex congenital lesions, valvular heart disease, cardiomyopathy, and aortopathy, and suggest an approach to risk stratification. Based on a review of the literature, we report features that pose an increased risk of adverse maternal and fetal outcomes, which include poor maternal functional status; prior history of heart failure, arrhythmia, or cerebral vascular events; cyanosis; poor systemic ventricular function; and severe aortic or mitral stenosis. Pulmonary hypertension and Eisenmenger syndrome place women at exceedingly high risk for cardiovascular complications in pregnancy, including maternal and fetal death.

Original languageEnglish (US)
Pages (from-to)308-316
Number of pages9
JournalCongenital Heart Disease
Volume3
Issue number5
DOIs
StatePublished - 2008
Externally publishedYes

Fingerprint

Mothers
Pregnancy
Cardiovascular Pregnancy Complications
Heart Diseases
Heart Failure
Cardiac Arrhythmias
Eisenmenger Complex
Maternal Death
Cyanosis
Fetal Death
Ventricular Function
Mitral Valve Stenosis
Maternal Mortality
Aortic Valve Stenosis
Cardiovascular System
Cardiomyopathies
Pulmonary Hypertension
Blood Vessels
Cardiovascular Diseases
Hemodynamics

Keywords

  • Pregnancy
  • Risk assessment
  • Structural heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Radiology Nuclear Medicine and imaging

Cite this

Practical assessment of maternal cardiovascular risk in pregnancy. / Moghbeli, Nazanin; Pare, Emmanuelle; Webb, Gary.

In: Congenital Heart Disease, Vol. 3, No. 5, 2008, p. 308-316.

Research output: Contribution to journalArticle

Moghbeli, Nazanin ; Pare, Emmanuelle ; Webb, Gary. / Practical assessment of maternal cardiovascular risk in pregnancy. In: Congenital Heart Disease. 2008 ; Vol. 3, No. 5. pp. 308-316.
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