Cardiac disease in pregnancy contraindications to pregnancy: Difference between revisions
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:*Prior peripartum cardiomyopathy | :*Prior peripartum cardiomyopathy | ||
*Dilated or unstable aorta | *Dilated or unstable aorta | ||
:* [[Marfan's syndrome]] | :* [[Marfan's syndrome]] | ||
::*Aorta >45 mm: strongly discourage pregnancy | |||
::*Aorta is <40 mm: the risk is not as high, but there is no safe aortic diamter. | |||
::*Aorta 40-45 mm: Evaluate the rate of aortic growth and family history. Even after repair, Marfan's syndrome patients remain at risk of dissection in the residual aorta. | |||
* Severe [[cyanosis]] | * Severe [[cyanosis]] | ||
Revision as of 19:57, 10 October 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Absolute and relative contraindications to pregnancy include severe pulmonary arterial hypertension; severe fixed valve stenoses (AS,MS,PS,HOCM, coarctation; Class III or IV congestive heart failure with a left ventricular ejection fraction of < 40%; a history of peripartum cardiomyopathy; a dilated aorta such as in Marfan's syndrome with an aortic arch >40-45 mm; and severe cyanosis.
Conditions in Which Pregnancy is Advised Against
- Severe pulmonary arterial hypertension which is associated with a 30% to 50% risk of maternal mortality.
- Severe fixed obstructive lesions such as aortic stenosis, mitral stenosis, pulmonic stenosis, hypertrophic obstructive cardiomyopathy, coarctation of the aorta
- Left ventricular systolic dysfunction
- Class III or IV CHF, EF <40%
- Prior peripartum cardiomyopathy
- Dilated or unstable aorta
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- Aorta >45 mm: strongly discourage pregnancy
- Aorta is <40 mm: the risk is not as high, but there is no safe aortic diamter.
- Aorta 40-45 mm: Evaluate the rate of aortic growth and family history. Even after repair, Marfan's syndrome patients remain at risk of dissection in the residual aorta.
- Severe cyanosis