TY - CHAP M1 - Book, Section TI - HEART DISEASE IN PREGNANCY A1 - Halpern, Dan G. A1 - Sarma, Amy A1 - Economy, Katherine E. A1 - Valente, Anne Marie A2 - Fuster, Valentin A2 - Harrington, Robert A. A2 - Narula, Jagat A2 - Eapen, Zubin J. PY - 2017 T2 - Hurst's The Heart, 14e AB - SummaryThis chapter discusses cardiovascular disease in pregnancy. Cardiovascular disease complicates >1% of pregnancies and is the cause of one-fifth of nonobstetric maternal deaths. Women with cardiovascular disease should receive counseling on maternal and fetal risks prior to conceiving. Pregnancy is not advised in patients with certain high-risk conditions (see accompanying Hurst’s Central Illustration). Women with other types of cardiovascular disease should undergo a complete work-up if considering pregnancy; additionally, anticipated or potential events should be carefully planned for and medications should be reviewed for their safety in pregnancy. Up to 10% of pregnancies are complicated by hypertensive disorders, but many other types of cardiovascular disease may develop (for example, peripartum cardiomyopathy) or present particular challenges (for example, existing valvular disease, aortic dilatation, or some types of congenital heart disease). Additionally, some previously undetected cardiovascular disease can become symptomatic in pregnancy (for example, valvular heart disease or congenital heart disease). During pregnancy, distinguishing between normal pregnancy symptoms and concerning cardiac manifestations is often challenging, but various symptoms, and any that arise after 20 weeks and become progressively worse or that significantly impair performance of daily activities, should prompt further evaluation. Pregnant women with cardiovascular conditions should be cared for by expert, multidisciplinary teams. Although obstetric complications are higher in women with cardiovascular disease, most women will be able to undergo successful spontaneous vaginal delivery with careful monitoring. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1191188650 ER -