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Tytuł pozycji:

Pregnancy and cardiovascular disease.

Tytuł:
Pregnancy and cardiovascular disease.
Autorzy:
Ramlakhan KP; Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Johnson MR; Academic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, UK.
Roos-Hesselink JW; Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands. .
Źródło:
Nature reviews. Cardiology [Nat Rev Cardiol] 2020 Nov; Vol. 17 (11), pp. 718-731. Date of Electronic Publication: 2020 Jun 09.
Typ publikacji:
Journal Article; Review
Język:
English
Imprint Name(s):
Original Publication: London : Nature Pub. Group
MeSH Terms:
Cardiovascular Physiological Phenomena*
Diabetes, Gestational/*metabolism
Hypertension, Pregnancy-Induced/*physiopathology
Pregnancy/*physiology
Pregnancy Complications, Cardiovascular/*physiopathology
Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/physiopathology ; Acute Coronary Syndrome/therapy ; Aortic Dissection/diagnosis ; Aortic Dissection/physiopathology ; Aortic Dissection/therapy ; Antihypertensive Agents/therapeutic use ; Arrhythmias, Cardiac/diagnosis ; Arrhythmias, Cardiac/physiopathology ; Arrhythmias, Cardiac/therapy ; Aspirin/therapeutic use ; Cardiac Output ; Cardiomyopathies/diagnosis ; Cardiomyopathies/physiopathology ; Cardiomyopathies/therapy ; Diabetes, Gestational/diagnosis ; Diabetes, Gestational/therapy ; Disease Progression ; Endocarditis/diagnosis ; Endocarditis/physiopathology ; Endocarditis/therapy ; Female ; Humans ; Hypertension/physiopathology ; Hypertension, Pregnancy-Induced/diagnosis ; Hypertension, Pregnancy-Induced/drug therapy ; Hypoglycemic Agents/therapeutic use ; Maternal Age ; Obesity, Maternal/metabolism ; Obesity, Maternal/physiopathology ; Platelet Aggregation Inhibitors/therapeutic use ; Pre-Eclampsia/physiopathology ; Pre-Eclampsia/prevention & control ; Pre-Eclampsia/therapy ; Pregnancy/metabolism ; Pregnancy Complications, Cardiovascular/diagnosis ; Pregnancy Complications, Cardiovascular/therapy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/physiopathology ; Pregnancy Complications, Infectious/therapy ; Pregnancy in Diabetics/metabolism ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/drug therapy ; Venous Thromboembolism/physiopathology
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Substance Nomenclature:
0 (Antihypertensive Agents)
0 (Hypoglycemic Agents)
0 (Platelet Aggregation Inhibitors)
R16CO5Y76E (Aspirin)
Entry Date(s):
Date Created: 20200611 Date Completed: 20201026 Latest Revision: 20221207
Update Code:
20240104
DOI:
10.1038/s41569-020-0390-z
PMID:
32518358
Czasopismo naukowe
Cardiovascular disease complicates 1-4% of pregnancies - with a higher prevalence when including hypertensive disorders - and is the leading cause of maternal death. In women with known cardiovascular pathology, such as congenital heart disease, timely counselling is possible and the outcome is fairly good. By contrast, maternal mortality is high in women with acquired heart disease that presents during pregnancy (such as acute coronary syndrome or aortic dissection). Worryingly, the prevalence of acquired cardiovascular disease during pregnancy is rising as older maternal age, obesity, diabetes mellitus and hypertension become more common in the pregnant population. Management of cardiovascular disease in pregnancy is challenging owing to the unique maternal physiology, characterized by profound changes to multiple organ systems. The presence of the fetus compounds the situation because both the cardiometabolic disease and its management might adversely affect the fetus. Equally, avoiding essential treatment because of potential fetal harm risks a poor outcome for both mother and child. In this Review, we examine how the physiological adaptations during pregnancy can provoke cardiometabolic complications or exacerbate existing cardiometabolic disease and, conversely, how cardiometabolic disease can compromise the adaptations to pregnancy and their intended purpose: the development and growth of the fetus.

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