Cardiac disease in pregnancy

Bhatla, Neerja; Lal, Sunil K.; Behera, Geeta; Kriplani, Alka; Mittal, Suneeta; Agarwal, Nutan; Kk, Talwar

doi:10.1016/s0020-7292(03)00159-0

Cited by 163 publications

(127 citation statements)

References 18 publications

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“…A number of studies have shown that medical co‐morbidities such as hypertension,9 cardiac disease,25 asthma,26 inflammatory disease,11 mental health problems,27 infection,9 musculoskeletal disorders11 and neurological conditions11 were associated with maternal morbidity and mortality. In contrast to some previous literature this study did not find an association between obesity and maternal mortality 17.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with maternal mortality at advanced maternal age: a population‐based case–control study

McCall

Nair

Knight

2016

BJOG

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ObjectiveThis study aimed to examine the factors associated with maternal mortality among women aged ≥35 years.DesignUnmatched population based case–control study.SettingUnited Kingdom.PopulationBetween 2009 and 2012, 105 cases of maternal deaths aged ≥35 years were extracted from the surveillance database of the MBRRACE‐UK confidential enquiries into maternal deaths in the UK. In addition, 766 controls aged ≥35 years were identified from the UK Obstetric Surveillance System (2005–2012).MethodsRisk factors known to be associated with maternal mortality and morbidity and for which data were available were examined for their association with maternal mortality among women ≥35 years using logistic regression analysis.Main outcome measuresOdds ratios and 95% confidence intervals associated with maternal death.ResultsFive factors were found to be significantly associated with increased odds of death among women aged ≥35 years: smoking during pregnancy (adjusted odds ratio (aOR) 2.06, 95% CI 1.13–3.75), inadequate use of antenatal care (aOR 23.62, 95% CI 8.79–63.45), medical co‐morbidities (aOR 5.92, 95% CI 3.56–9.86) and previous pregnancy problems (aOR 2.06, 95% CI 1.23–3.45). The odds associated with death increased by 12% per year increase in age (aOR 1.12, 95% CI 1.02–1.22).ConclusionAge was associated with maternal mortality even after adjusting for other known risk factors. Importantly, this study showed an association between maternal mortality and smoking among women aged 35 years or older. It emphasises the importance of public health action to reduce smoking levels and address trends in rising maternal age.Tweetable abstractSmoking is a risk factor for maternal death for those aged over 35 years.

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Section: Discussionmentioning

confidence: 99%

Factors associated with maternal mortality at advanced maternal age: a population‐based case–control study

McCall

Nair

Knight

2016

BJOG

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“…Bhatla et al [21] showed that there were more fetal complications, as well as more preterm and low-birth-weight neonates, among patients in NYHA class III/IV than among those in NYHA class I/II. The incidence of premature delivery was elevated among patients with HF in the present study.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for heart failure during pregnancy among Chinese women with cardiac disease

Lin

2015

Intl J Gynecology & Obste

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“…1 Physiological changes of pregnancy worsen the cardiac symptoms especially in the third trimester. Obstetrical and neonatal complications also occur more frequently in women with heart disease.…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management of a parturient with severe mitral stenosis and pulmonary hypertension for caesarean section

Gupta

Jain

Sharma

et al. 2015

Current Medicine Research and Practice

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Pregnancy itself is a stressful period for women which gets further compounded by the presence of mitral stenosis (MS). The interaction between the hyperdynamic cardiovascular changes of pregnancy, i.e. increased cardiac output, increased heart rate and increased oxygen consumption and the narrowed mitral valve are to be understood to avoid the complications occurring during labour and delivery. Pulmonary hypertension (PH) is rarely seen in pregnancy but can result in high maternal mortality secondary to increased risk of congestive heart failure, arrhythmia and sudden cardiac arrest. In this report, we discuss the management of a case of severe MS compounded with PH requiring caesarean section. Case reportA 25-year-old, 38 +4 weeks gestation G 1 P 0 with known rheumatic heart disease and severe MS was scheduled for elective caesarean section (CS) in view of intrauterine growth restriction and severe oligohydramnios. Her first trimester was uneventful. In second trimester, she developed fever and breathlessness for which she presented to the obstetric department and was managed conservatively with antipyretics and analgesics and was discharged home in stable condition. No cardiology opinion was taken at the time. She again developed cough and breathlessness in third trimester. A complete cardiological evaluation was done. Her echocardiography revealed severe MS with severe PH. Balloon mitral c u r r e n t m e d i c i n e r e s e a r c h a n d p r a c t i c e x x x ( 2 0 1 5 ) x x x -x x x Available online xxx Keywords: Anaesthesia Parturient Mitral stenosis Caesarean section Invasive blood pressure monitoring a b s t r a c tMitral stenosis is the most common valvular heart disease seen during pregnancy. Conception is discouraged because of increased morbidity and mortality in cases where pulmonary hypertension develops during the course of mitral stenosis. We present the anaesthetic management of a 25-year-old 38 +4 weeks parturient with severe mitral valve stenosis and pulmonary hypertension. We preferred invasive blood pressure monitoring to observe early haemodynamic changes and arterial blood gas analysis, so that necessary interventions could be taken at the earliest.Please cite this article in press as: Gupta AK, et al. Anaesthetic management of a parturient with severe mitral stenosis and pulmonary hypertension for caesarean section, Curr Med Res Pract. (2015), http://dx.

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Cardiac disease in pregnancy

Cited by 163 publications

References 18 publications

Factors associated with maternal mortality at advanced maternal age: a population‐based case–control study

Factors associated with maternal mortality at advanced maternal age: a population‐based case–control study

Risk factors for heart failure during pregnancy among Chinese women with cardiac disease

Anaesthetic management of a parturient with severe mitral stenosis and pulmonary hypertension for caesarean section

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