Featured Research

from universities, journals, and other organizations

Number of patients with cardiac problems during pregnancy is increasing

Date:
August 29, 2011
Source:
European Society of Cardiology
Summary:
Pre-existing heart disease is rarely a contraindication to pregnancy -- indeed, many women with heart disorders tolerate pregnancy well -- but it remains a "major concern" that complications are frequent and in some cases may be life-threatening for both the mother and her child. In Europe maternal heart disease has now become the major cause of maternal death during pregnancy.

Pre-existing heart disease is rarely a contraindication to pregnancy -- indeed, many women with heart disorders tolerate pregnancy well -- but it remains a "major concern" that complications are frequent and in some cases may be life-threatening for both the mother and her child. In Europe maternal heart disease has now become the major cause of maternal death during pregnancy.

New ESC Guidelines on the management of cardiovascular disease in pregnancy are published in the European Heart Journal. Their publication, say the authors, comes at a time when the risk of cardiovascular disease in pregnancy continues to rise in developed countries, mainly because of today's older age at first pregnancy and with it a concomitant increase in risks of diabetes, hypertension and obesity. In addition, the treatment of congenital heart disease has improved, resulting in a greater number of women with heart disease reaching childbearing age. Nevertheless, congenital heart disease remains the most frequent cardiovascular disease in pregnancy (75-83%), with hypertensive disorders the most frequent cardiovascular events.

It is because of their increasing prevalence and potential severity that the Guidelines describe careful screening for heart disease, appropriate risk assessment and counseling as "crucial." Their importance, of course, take on added value when considered in the context of fetal as well as maternal health.

The Guidelines make clear that much of the screening, risk assessment and counseling can be effectively performed in primary care, but, once a cardiovascular disease is suspected or even confirmed, its management is best undertaken by interdisciplinary teams. High risk patients are recommended for treatment in specialised centres. Thus, diagnostic procedures and interventions should be performed by specialists with expertise in the techniques and experience in treating pregnant patients.

The general recommendations of the Guidelines are supported by eight sections on specific disease groups: congenital heart disease, aortic disease, valvular heart disease, coronary artery disease, cardiomyopathies, arrhythmias, hypertensive disorders and venous thromboembolism. A separate section is devoted to cardiovascular drugs during pregnancy. Management recommendations include follow-up during pregnancy, medical therapy and intervention where appropriate, as well as recommendations for delivery and postpartum care.

However, the Guidelines also note that evidence from prospective or randomised studies in this field are sparse, with recommendations mostly corresponding to evidence level C. Thus, with so many recommendations largely based on retrospective data and broad expert consensus, the authors concede that registries and prospective studies are urgently needed to improve the state of knowledge.

It is this lack of evidence, they say, which still leaves some issues inconclusively resolved. Thus, while there is agreement that severe pulmonary hypertension, for example, is a contraindication for pregnancy, there is no clear guidance when that risk becomes acceptable in the presence of less severe pulmonary hypertension. Unfortunately, say the authors, conclusive data with this regard are still lacking and make precise recommendations impossible. Anticoagulation therapy during pregnancy in patients with artificial valves or other indications (for anticoagulation) is another controversial area in which prospective studies are urgently needed.

Nevertheless, despite such lack of solid evidence, the authors conclude: "We are convinced that this guideline document is an important contribution and will be considered very helpful for the management of cardiovascular disease during pregnancy in clinical practice."

The Guidelines will be formally introduced at a special session of the 2011 ESC Congress in Paris on 30th August.


Story Source:

The above story is based on materials provided by European Society of Cardiology. Note: Materials may be edited for content and length.


Journal Reference:

  1. V. Regitz-Zagrosek, C. B. Lundqvist, C. Borghi, R. Cifkova, R. Ferreira, J.-M. Foidart, J. S. R. Gibbs, C. Gohlke-Baerwolf, B. Gorenek, B. Iung, M. Kirby, A. H. E. M. Maas, J. Morais, P. Nihoyannopoulos, P. G. Pieper, P. Presbitero, J. W. Roos-Hesselink, M. Schaufelberger, U. Seeland, L. Torracca, J. Bax, A. Auricchio, H. Baumgartner, C. Ceconi, V. Dean, C. Deaton, R. Fagard, C. Funck-Brentano, D. Hasdai, A. Hoes, J. Knuuti, P. Kolh, T. McDonagh, C. Moulin, D. Poldermans, B. A. Popescu, Z. Reiner, U. Sechtem, P. A. Sirnes, A. Torbicki, A. Vahanian, S. Windecker, H. Baumgartner, C. Deaton, C. Aguiar, N. Al-Attar, A. A. Garcia, A. Antoniou, I. Coman, U. Elkayam, M. A. Gomez-Sanchez, N. Gotcheva, D. Hilfiker-Kleiner, R. G. Kiss, A. Kitsiou, K. T. S. Konings, G. Y. H. Lip, A. Manolis, A. Mebaaza, I. Mintale, M.-C. Morice, B. J. Mulder, A. Pasquet, S. Price, S. G. Priori, M. J. Salvador, A. Shotan, C. K. Silversides, S. O. Skouby, J.-I. Stein, P. Tornos, N. Vejlstrup, F. Walker, C. Warnes. ESC Guidelines on the management of cardiovascular diseases during pregnancy: The Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). European Heart Journal, 2011; DOI: 10.1093/eurheartj/ehr218

Cite This Page:

European Society of Cardiology. "Number of patients with cardiac problems during pregnancy is increasing." ScienceDaily. ScienceDaily, 29 August 2011. <www.sciencedaily.com/releases/2011/08/110829115422.htm>.
European Society of Cardiology. (2011, August 29). Number of patients with cardiac problems during pregnancy is increasing. ScienceDaily. Retrieved July 23, 2014 from www.sciencedaily.com/releases/2011/08/110829115422.htm
European Society of Cardiology. "Number of patients with cardiac problems during pregnancy is increasing." ScienceDaily. www.sciencedaily.com/releases/2011/08/110829115422.htm (accessed July 23, 2014).

Share This




More Health & Medicine News

Wednesday, July 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Courts Conflicted Over Healthcare Law

Courts Conflicted Over Healthcare Law

AP (July 22, 2014) Two federal appeals courts issued conflicting rulings Tuesday on the legality of the federally-run healthcare exchange that operates in 36 states. (July 22) Video provided by AP
Powered by NewsLook.com
Why Do People Believe We Only Use 10 Percent Of Our Brains?

Why Do People Believe We Only Use 10 Percent Of Our Brains?

Newsy (July 22, 2014) The new sci-fi thriller "Lucy" is making people question whether we really use all our brainpower. But, as scientists have insisted for years, we do. Video provided by Newsy
Powered by NewsLook.com
Scientists Find New Way To Make Human Platelets

Scientists Find New Way To Make Human Platelets

Newsy (July 22, 2014) Boston scientists have discovered a new way to create fully functioning human platelets using a bioreactor and human stem cells. Video provided by Newsy
Powered by NewsLook.com
Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

Gilead's $1000-a-Pill Drug Could Cure Hep C in HIV-Positive People

TheStreet (July 21, 2014) New research shows Gilead Science's drug Sovaldi helps in curing hepatitis C in those who suffer from HIV. In a medical study, the combination of Gilead's Hep C drug with anti-viral drug Ribavirin cured 76% of HIV-positive patients suffering from the most common hepatitis C strain. Hepatitis C and related complications have been a top cause of death in HIV-positive patients. Typical medication used to treat the disease, including interferon proteins, tended to react badly with HIV drugs. However, Sovaldi's %1,000-a-pill price tag could limit the number of patients able to access the treatment. TheStreet's Keris Lahiff reports from New York. Video provided by TheStreet
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins