Pregnancy after myocardial infarction and a coronary artery bypass graft

Dufour, P; Bérard, J; Vinatier, D.; Subtil, D.; Guionet, B.; Bourzoufi, K.; Michon, P; Puech, F

doi:10.1007/bf02505335

Cited by 12 publications

(6 citation statements)

References 21 publications

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“…The second stage of labor is associated with an increase in hemodynamic and oxidative cardiac stress, likely secondary to strenuous Valsalva necessary for fetal expulsion 4,18,21 . Operative vaginal delivery and a shortened second stage will reduce the amount of Valsalva necessary for delivery, thereby reducing the oxidative stress on the heart 4,18,21,23 . Cesarean section, on the other hand, is associated with an increased risk of hemorrhage, infection and large fluid shifts 21 .…”

Section: Discussionmentioning

confidence: 99%

Mode of Delivery for a Term Patient with Spontaneous Coronary Artery Dissection

2018

ARC Journal of Gynecology and Obstetrics

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Section: Discussionmentioning

confidence: 99%

Mode of Delivery for a Term Patient with Spontaneous Coronary Artery Dissection

2018

ARC Journal of Gynecology and Obstetrics

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“…Dufour et al 18 reported data on pregnancy in patients who had had a previous myocardial infarction with or without prior CABG. In the majority of patients who died, their death occurred at the time of myocardial infarction, and maternal mortality rate was the greatest if myocardial infarction occurred late in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Ischaemic heart disease and pregnancy: the tale of two stories

Matshela

2018

CVJA

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SummaryIschaemic heart disease (IHD) is presumed to be rare in pregnancy. Based on that assumption, patients go undiagnosed or undertreated. IHD in pregnancy frequently occurs as a result of an unusual aetiology, therefore each patient needs to be managed individually since each may present differently. This may pose challenges to the consulting clinician. Pregnancy itself is a risk factor for cardiovascular disease, due to its associated hypercoagulable state. From current reports, the prevalence of IHD in females is increasing due to lifestyle changes, including cigarette smoking, diabetes and stress. In our modern societies, women delay childbearing until they are older, allowing time for risk factors to cluster. Although presumed to be rare in pregnant women, IHD is currently estimated to occur three to four times more often during pregnancy in middle– and high–income women, warranting an extensive review highlighting cases of IHD in pregnancy.

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“…Cardiac surgery can be safely done after 28 weeks of gestational age and immediately after cesarean section. [42][43][44] Cardiopulmonary bypass during pregnancy has been associated with a fetal mortality rate of 16% to 33%. During CPB decreasing of maternal mean arterial pressure may cause uteroplacental hypoperfusion, can precipitate uterine contractions.…”

Section: Coronary Artery Bypass Graftingmentioning

confidence: 99%

Coronary Artery Diseases During Pregnancy: Minimizing Adverse Consequences and Improving Clinical Outcome

Haque¹,

Hosain

Islam

et al. 2021

Cardiovasc. j.

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Coronary artery disease in pregnancy is a catastrophic situation that may endanger the lives of both the mother and the fetus. Cardiac diseases may account for up to 15% of maternal mortality. Pregnancy may increase the risk of acute myocardial infarction up to 4-fold. Various hemodynamic derangements may occur during pregnancy including expansion of plasma and blood volume, compression of inferior vena cava and fall in both systemic and pulmonary vascular resistances. If pregnant women present with acute coronary artery disease, medical management should be attempted first and if any intervention or surgery is needed, efforts must be made to lower the risk. A multidisciplinary approach is essential involving obstetrician, cardiologist, cardiac surgeons, anesthesiologist and neonatologists or pediatrician. Pregnancy is considered to be a relative contraindication to thrombolytic therapy due to some complications. Revascularization may be considered in acute coronary syndrome in pregnant women like other nonpregnant patients. Primary per cutaneous coronary intervention or coronary artery bypass graft have been performed successfully during pregnancy and may be considered as therapeutic option in pregnancy in selective cases. Percutaneous coronary intervention (PCI) is considered to be relatively safe for maternal and fetal survival during pregnancy. Main worry in PCI is radiation exposure and need to dual antiplatelet therapy. Bare metal stent is preferred during pregnancy because of shorter duration of anticoagulation therapy. Early second trimester is the optimum surgical period to coronary artery bypass surgery (CABG) in pregnant women. Coronary artery bypass surgery can be safely done after 28 weeks of gestational age and immediately after cesarean section. Early detection, a multidisciplinary approach and timely interventions must be considered in coronary artery disease in pregnancy for better obstetric outcome. Cardiovasc j 2021; 14(1): 61-69

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Pregnancy after myocardial infarction and a coronary artery bypass graft

Cited by 12 publications

References 21 publications

Mode of Delivery for a Term Patient with Spontaneous Coronary Artery Dissection

Mode of Delivery for a Term Patient with Spontaneous Coronary Artery Dissection

Ischaemic heart disease and pregnancy: the tale of two stories

Coronary Artery Diseases During Pregnancy: Minimizing Adverse Consequences and Improving Clinical Outcome

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