Congenital heart disease reproduction

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Congenital heart disease Microchapters


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Priyamvada Singh, MBBS [2] Assistant Editor-In-Chief: Kristin Feeney, B.S. [3]

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2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1]

Recommendations for Pregnancy and Contraception (DO NOT EDIT)[1]

Class I
"1. Patients with CHD should have consultation with an ACHD expert before they plan to become pregnant to develop a plan for management of labor and the postpartum period that includes consideration of the appropriate response to potential complications. This care plan should be made available to all providers. (Level of Evidence: C) "
"2. Patients with intracardiac right-to-left shunting should have fastidious care of intravenous lines to avoid paradoxical air embolus. (Level of Evidence: C) "
"3. Prepregnancy counseling is recommended for women receiving chronic anticoagulation with warfarin to enable them to make an informed decision about maternal and fetal risks. [2][3][4](Level of Evidence: B) "
Class III
"1. The estrogen-containing oral contraceptive pill is not recommended for ACHD patients at risk of thromboembolism, such as those with cyanosis related to an intracardiac shunt, severe PAH, or Fontan repair. (Level of Evidence: C) "
Class IIa
"1. Meticulous prophylaxis for deep venous thrombosis, including early ambulation and compression stockings, can be useful for all patients with intracardiac right-to-left shunt. Subcutaneous heparin or low-molecular-weight heparin is reasonable for prolonged bed rest. Full anticoagulation can be useful for the high-risk patient. (Level of Evidence: C) "


  1. 1.0 1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.
  2. Vitale N, De Feo M, De Santo LS, Pollice A, Tedesco N, Cotrufo M (1999). "Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves". Journal of the American College of Cardiology. 33 (6): 1637–41. PMID 10334435. Retrieved 2012-11-07. Unknown parameter |month= ignored (help)
  3. Sareli P, England MJ, Berk MR, Marcus RH, Epstein M, Driscoll J, Meyer T, McIntyre J, van Gelderen C (1989). "Maternal and fetal sequelae of anticoagulation during pregnancy in patients with mechanical heart valve prostheses". The American Journal of Cardiology. 63 (20): 1462–5. PMID 2729133. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  4. van Driel D, Wesseling J, Sauer PJ, van Der Veer E, Touwen BC, Smrkovsky M (2001). "In utero exposure to coumarins and cognition at 8 to 14 years old". Pediatrics. 107 (1): 123–9. PMID 11134445. Retrieved 2012-11-07. Unknown parameter |month= ignored (help)

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