The Obstetrician & Gynaecologist 2007;9:1:15-20
doi: 10.1576/toag.9.1.015.27291
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
Cardiac disease in pregnancy. Part 1: congenital heart disease
Emily Gelson, BS MB BCh, Clinical Fellow in Pregnancy and Heart Disease1,
Mark Johnson, PhD MRCP MRCOG, Reader in Obstetrics and Obstetric Medicine2,
Michael Gatzoulis, MD PhD MRCP, Professor of Cardiology, Congenital Heart Disease3 and
Anselm Uebing, MD, Fellow in Adult Congenital Heart Disease4
1. Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK Email: e.gelson{at}imperial.ac.uk (corresponding author)
2. Chelsea and Westminster Hospital, London, UK
3. Adult Congenital Heart Disease Unit, Royal Brompton and Harefield NHS Trust and; National Heart and Lung Institute, Imperial College, London SW3 6NP, UK
4. Adult Congenital Heart Disease Unit, Royal Brompton and Harefield NHS Trust and; National Heart and Lung Institute, Imperial College, London, UK
Key content:
- Heart disease is now the most common indirect cause of maternal death in the United Kingdom.
- Neonatal morbidity and mortality from fetal growth restriction and prematurity are markedly increased in women with heart disease.
- Women with congenital heart disease should ideally have a planned pregnancy managed by a multidisciplinary team which includes obstetricians, cardiologists, anaesthetists, neonatologists and midwives.
Learning objectives:
- To understand the changes to cardiovascular physiology during pregnancy.
- To recognise the risk factors for poor pregnancy outcome in cardiac disease.
- To understand the general management principles for women with cardiac disease in pregnancy.
Ethical issues:
- Should we be recommending termination of pregnancy in women with high risk cardiac lesions?
- How do we manage women who become pregnant against medical advice?
- What is the role of surrogacy in women with high risk cardiac lesions?
Please cite this article as: Gelson E, Johnson M, Gatzoulis M, Uebing A. Cardiac disease in pregnancy. Part 1: congenital heart disease. The Obstetrician & Gynaecologist 2007;9:15–20.
Keywords acquired heart disease / congenital heart disease / neonatal outcome / pregnancy / prepregnancy counselling / risk assessment
Copyright © 2007 by the Royal College of Obstetricians and Gynaecologists.
