| Cardiovascular diseases in pregnancy. | |
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MedLine Citation:
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PMID: 21603561 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Cardiovascular diseases arise during 0,2% to 4% of all pregnancies in the industrialized world. In Germany, this type of complication, which is sometimes lethal, affects approximately 30 000 pregnant women per year. METHODS: We performed a simple literature search in the NCBI databases for publications that appeared from 2008 to 2010 and that contained the search terms "pregnancy" and one of the following: "valvular disease," "endocarditis," "coronary heart disease," "cardiomyopathy," "hypertension," "anticoagulation." We also took consideration of the relevant international medical society guidelines and of the new database of the Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie in Berlin (Embryotox). RESULTS: There is a rising incidence, not only of hypertension during pregnancy, but also of valvular heart disease during pregnancy. Severe valvular stenosis, particularly mitral stenosis, raises the risk of pulmonary edema and should be treated before pregnancy, by valvuloplasty or surgically. Women with high-grade valvular insufficiency and restricted left-ventricular function are at risk of heart failure. For women with mechanical heart valves, the type of anticoagulation during pregnancy must be discussed on an individual basis. Coumarin derivatives are associated with an elevated risk of hemorrhage as well as coumarin embryopathy; recent studies have shown that the latter risk is low and dose-dependent. Spontaneous dissection of the coronary arteries is best treated by catheter intervention with the implantation of a bare metal stent. CONCLUSION: Women of child-bearing age who are at risk for, or already have, cardiovascular disease should receive early counseling and treatment, not just from their family physician, but from an interdisciplinary team composed of gynecologists, cardiologists, and, if necessary, cardiac surgeons. |
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Authors:
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Vera Regitz-Zagrosek; Ute Seeland; Annette Geibel-Zehender; Christa Gohlke-Bärwolf; Irmtraut Kruck; Christof Schaefer |
Publication Detail:
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Type: Journal Article Date: 2011-04-22 |
Journal Detail:
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Title: Deutsches Ärzteblatt international Volume: 108 ISSN: 1866-0452 ISO Abbreviation: Dtsch Arztebl Int Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-05-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101475967 Medline TA: Dtsch Arztebl Int Country: Germany |
Other Details:
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Languages: eng Pagination: 267-73 Citation Subset: IM |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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