Document Detail

Pericardial disease in pregnancy.
MedLine Citation:
PMID:  12756478     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is no evidence that pregnancy affects susceptibility to pericardial disease. However, when such a condition occurs, its proper diagnosis and management may be crucial for the outcome of the pregnancy.
INCIDENCE AND DIAGNOSIS: Hydropericardium is the most frequent form of pericardial involvement in pregnancy. It is typically a small, clinically silent pericardial effusion present in the third trimester in approximately 40% of healthy pregnant women. Small amounts of fetal pericardial fluid (< 2 mm in echocardiography, in diastole) can be detected after 20 weeks of gestation. Larger effusions should raise clinical concern for hydrops fetalis, Rh disease, hypoalbuminemia, and infectious or autoimmune disorder. Wide varieties of etiologic forms of pericardial diseases occur sporadically in pregnant women. Significant symptoms, electrocardiographic changes, or physiologic impairment warrant hospitalization.
TREATMENT: Most pericardial disorders are managed during pregnancy as in nonpregnant patients (i.e., nonsteroidal antiinflammatory drugs for acute, antibiotics and drainage for purulent pericarditis, and corticosteroids for systemic autoimmune disorders). However, colchicine is contraindicated in pregnancy, and pericardiocentesis should be performed only for very large effusions causing clinical signs of cardiac tamponade or if presence of suppurative, tuberculous or neoplastic pericardial effusion is suspected. Echocardiographic guidance of pericardiocentesis is preferred to fluoroscopic guidance in order to avoid fetal X-ray exposure. Pericardiectomy should be reserved for significant pericardial constriction and resistant bacterial infections. Delivery of normal infants in term after pericardiocentesis or pericardiectomy is expected, whenever natural history of causative disease allows. Pericardiectomy itself is not a contraindication for subsequent successful pregnancies.
Arsen D Ristić; Petar M Seferović; Aleksandar Ljubić; Ida Jovanović; Gorica Ristić; Sabine Pankuweit; Miodrag Ostojić; Bernhard Maisch
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Herz     Volume:  28     ISSN:  0340-9937     ISO Abbreviation:  Herz     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-05-20     Completed Date:  2003-12-09     Revised Date:  2013-07-15    
Medline Journal Info:
Nlm Unique ID:  7801231     Medline TA:  Herz     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  209-15     Citation Subset:  IM    
University Institute for Cardiovascular Disease, Clinical Center of Serbia, Belgrade, Serbia and Montenegro. arsenr@eunet.yu
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MeSH Terms
Colchicine / contraindications
Diagnosis, Differential
Infant, Newborn
Pericardial Effusion / diagnosis*,  etiology,  therapy
Pericardiocentesis / contraindications
Pericarditis / diagnosis*,  etiology,  therapy
Pregnancy Complications, Cardiovascular / diagnosis*,  etiology,  therapy
Reg. No./Substance:

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