![]() Pneumococcal & influenza vaccines are recommended.Avoid contact with persons who have respiratory infections including common colds and flu condition. ![]() Weight gain should not exceed 12 kg during pregnancy.Light house work and walking is permitted but no heavy work.Bed rest: At least 10 hours each night and half an hour after each meal.Management According to the Functional Grade Mitral stenosis, NYHA class I and II NYHA = New York Heart Association&ACOG 1996.Risk of Maternal Mortality Heart Diseases Minimal Risk: Mortality 0-1% Marfan syndrome with aortic involvement Moderate Risk: Mortality 15-25% Mitral stenosis, NYHA class III and IV Aortic stenosis Aortic coarctation without valvular involvement Fallot tetralogy, uncorrected Previous myocardial infarction Marfan syndrome, normal aorta NYHA = New York Heart Association & ACOG 1996.Aortic coarctation with valvular involvement.Risk of Maternal Mortality Heart Diseases Major Risk: Mortality 25-50% Congenital heart disease risks in the fetus with affected family members.Risk of Maternal Mortality: moderate and severe (NYHA & ACOG \).The functional cardiac (Class III & IV NYHA).Preconception Care 5-Prevention - postponing of pregnancy according to: Surgical correction when indicated: Commissurotomy or M valve replacement for MS, coronary bypass for ischemic heart or correction of cyanotic heart diseases.Associated Medical disorders: Anemia, control of diabetes or thyroid disorder.Preconception Care 4-Managing or correction before pregnancy: ACE Inhibitors (at all trimesters: Fetal renal dysgenesis).Warfarin: (Except with mechanical valves ) Embryopathy (abnormal cartilage and bone formation).3-Medications contraindicated in pregnancy should be stopped: Preconception Care 1-Prenatal folic acid 400-500ug/d 2-Rubella immune status immunize if not immune. ![]() If indicated, heart catheterization.Ĭlassification of Heart Diseases in Pregnancy Incidence: 1% of all pregnancies 1-Rheumatic valve diseases (still the most common in the developing countries) MS, MR, DM, AS, AR 2-Congenital disorders (The most common in the developed countries) ASD,VSD,PDA, coarcitation of the aorta, Fallot's tetralogy, Eisenminger syndrome and Marfan syndrome 3-Others: Arrhythmias,ischemic heart disease and cardiomyopathy. ductus arteriosisĬlinical Indicators of Heart Disease during Pregnancy Symptoms: Ĭlinical Indicators of Heart Disease during Pregnancy Signs Cyanosis Clubbing of fingers Persistent neck vein distension Systolic murmur grade≥ 3/6 Diastolic murmur Cardiomegaly Persistent arrhythmia Pregnant women who have none of these findings rarely have serious heart disease.ĭiagnostic Study & Normal Pregnancy Findings ECG: 15° left-axis deviation Echocardiography: Tricuspid regurgitation and significantly increased left-atria size and left-ventricular outflow cross sectional area Chest X’ray: heart silhouette is larger in pregnancy however, gross cardiomegaly can be excluded.
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