Department of Cardiology, Brigham and Women's Hospital, Boston, MA, USA.
Department of Internal Medicine, John Hopkins University, Baltimore, MD, USA.
Curr Cardiol Rep. 2023 Sep;25(9):1065-1073. doi: 10.1007/s11886-023-01928-0. Epub 2023 Aug 4.
Cardiovascular disease is the leading cause of maternal mortality in the USA. All cardiovascular care providers should have a foundational knowledge on the management of pregnant individuals with heart disease. This focused review touches on several key cardio-obstetric themes.
Many individuals with cardiovascular disease can safely undergo pregnancy, but should have counseling preconception to optimize cardiac status. There are several cardiovascular conditions that are high risk for maternal mortality and morbidity. These individuals should be adequately counseled preconception and offered reliable birth control. The approach to a high-risk pregnant patient with cardiac disease is best managed by a multidisciplinary team to address potential maternal and fetal complications. Identification of at risk individuals can be estimated preconception with several risk scores. The development of risk scores to stratify and identify those at elevated risk during pregnancy is an area of continued research and development.
心血管疾病是美国孕产妇死亡的主要原因。所有心血管疾病护理提供者都应该对心脏病孕妇的管理有基本的了解。本重点综述涉及了几个关键的心脏产科主题。
许多患有心血管疾病的人可以安全地怀孕,但应该在怀孕前进行咨询,以优化心脏状况。有几种心血管疾病对孕产妇死亡率和发病率的风险很高。这些人应该在怀孕前得到充分的咨询,并提供可靠的避孕措施。患有心脏病的高危孕妇最好由多学科团队来管理,以解决潜在的母婴并发症。可以通过几种风险评分在怀孕前估计出高危个体。开发风险评分来分层和识别怀孕期间处于高风险的个体是一个持续研究和开发的领域。