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Pregnancy After Cardiac Surgery
Women with native heart valve disease who are considering getting pregnant should have a complete risk estimation to determine whether an intervention is required prior to becoming pregnant and, if so, to determine when it should be performed and what kind of surgical therapy will be used. Pregnancy...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720036/ https://www.ncbi.nlm.nih.gov/pubmed/36475179 http://dx.doi.org/10.7759/cureus.31133 |
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author | Makhija, Nidhi Tayade, Surekha Tilva, Hard Chadha, Arzoo Thatere, Utkarsh |
author_facet | Makhija, Nidhi Tayade, Surekha Tilva, Hard Chadha, Arzoo Thatere, Utkarsh |
author_sort | Makhija, Nidhi |
collection | PubMed |
description | Women with native heart valve disease who are considering getting pregnant should have a complete risk estimation to determine whether an intervention is required prior to becoming pregnant and, if so, to determine when it should be performed and what kind of surgical therapy will be used. Pregnancy is linked to early and late structural valve degeneration in women who have bioprostheses, suggesting a high reoperation rate. A mechanical valve during pregnancy increases the risk of maternal complications such as valve thrombosis and mortality. The claim that women with defective hearts should not become pregnant was driven by the high maternal death rate among cardiac patients who became pregnant. A preoperative anticoagulation therapy trial helped women scheduled for valve replacement to acquire complete information as to the choice of the prosthetic device. Integrated risk stratification scheme for pregnant patients with valvular heart disease, with WHO classification and an algorithmic approach to both preconception counseling and anticoagulation strategy as outlined here, as well as early referral to a cardiologist with expertise in the management of cardiac disease and pregnancy for these complex patients is recommended. However, in reality, some women present while pregnant and valve disease needs to be managed, balancing maternal outcome and fetal risk. In general, optimizing the hemodynamic situation of the mother is also beneficial to the fetus. However, cardiac surgery carries a high risk for the fetus. No anticoagulant regimen can be said to be entirely safe for use during pregnancy, as there is a degree of risk with each regimen. Therefore, this review has been done to find appropriate management for women dealing with such conditions. |
format | Online Article Text |
id | pubmed-9720036 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-97200362022-12-05 Pregnancy After Cardiac Surgery Makhija, Nidhi Tayade, Surekha Tilva, Hard Chadha, Arzoo Thatere, Utkarsh Cureus Cardiac/Thoracic/Vascular Surgery Women with native heart valve disease who are considering getting pregnant should have a complete risk estimation to determine whether an intervention is required prior to becoming pregnant and, if so, to determine when it should be performed and what kind of surgical therapy will be used. Pregnancy is linked to early and late structural valve degeneration in women who have bioprostheses, suggesting a high reoperation rate. A mechanical valve during pregnancy increases the risk of maternal complications such as valve thrombosis and mortality. The claim that women with defective hearts should not become pregnant was driven by the high maternal death rate among cardiac patients who became pregnant. A preoperative anticoagulation therapy trial helped women scheduled for valve replacement to acquire complete information as to the choice of the prosthetic device. Integrated risk stratification scheme for pregnant patients with valvular heart disease, with WHO classification and an algorithmic approach to both preconception counseling and anticoagulation strategy as outlined here, as well as early referral to a cardiologist with expertise in the management of cardiac disease and pregnancy for these complex patients is recommended. However, in reality, some women present while pregnant and valve disease needs to be managed, balancing maternal outcome and fetal risk. In general, optimizing the hemodynamic situation of the mother is also beneficial to the fetus. However, cardiac surgery carries a high risk for the fetus. No anticoagulant regimen can be said to be entirely safe for use during pregnancy, as there is a degree of risk with each regimen. Therefore, this review has been done to find appropriate management for women dealing with such conditions. Cureus 2022-11-05 /pmc/articles/PMC9720036/ /pubmed/36475179 http://dx.doi.org/10.7759/cureus.31133 Text en Copyright © 2022, Makhija et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiac/Thoracic/Vascular Surgery Makhija, Nidhi Tayade, Surekha Tilva, Hard Chadha, Arzoo Thatere, Utkarsh Pregnancy After Cardiac Surgery |
title | Pregnancy After Cardiac Surgery |
title_full | Pregnancy After Cardiac Surgery |
title_fullStr | Pregnancy After Cardiac Surgery |
title_full_unstemmed | Pregnancy After Cardiac Surgery |
title_short | Pregnancy After Cardiac Surgery |
title_sort | pregnancy after cardiac surgery |
topic | Cardiac/Thoracic/Vascular Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720036/ https://www.ncbi.nlm.nih.gov/pubmed/36475179 http://dx.doi.org/10.7759/cureus.31133 |
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