دانلود رایگان مقاله انگلیسی بیماری قلبی و بارداری - اشپرینگر 2017

ABSTRACT

Cardiac disease remains a major cause of morbidity and mortality in pregnant and post-partum women, although progress has been made, with specialist joint obstetric–cardiology clinics providing an integrated, safe and personalised service to these women. As a result, fewer non-specialist cardiologists are managing women in pregnancy with cardiovascular disease. The aim of this review is to provide a brief overview of current knowledge and practice in the field, with an emphasis on the major physiological changes which occur during pregnancy, focussing on progress through the trimesters, clinical assessment in pregnancy, management of delivery (concentrating on managed vaginal delivery), drug treatment, key conditions and risk assessment. The latter factor is particularly important in terms of being able to identify high-risk women earlier and to counsel them appropriately. Pregnant women with cardiovascular conditions can, with appropriate knowledge and counselling, be managed safely in specialist multidisciplinary services, but there is a need for cardiologists to understand the key changes and risks involved in pregnancy, delivery and the post-partum period.

CONCLUSION

Pregnancy presents the heart with a unique physiological challenge. An increasing number of women with cardiac disease are going through pregnancy successfully. The range of conditions encountered is wide, and many patients have congenital heart disease. There are multiple management challenges to achieve a successful outcome for mother and child. Pre-pregnancy counselling is vital, and specialist multi-disciplinary care by a specialist team is essential to ensure a successful outcome for mother and child.