Heart Disease With Pregnancy PDF

Heart Disease with Pregnancy Dr. Samar Hassan Mohammed Ali MBBS MD MSc MHPE Assistant professor ob.gyn. AAU Learning Outcomes By the end of this session you should be able to: Identify symptoms and signs of heart disease with pregnancy Manage the pregnancy, labour and deli...

Heart Disease with Pregnancy Dr. Samar Hassan Mohammed Ali MBBS MD MSc MHPE Assistant professor ob.gyn. AAU Learning Outcomes By the end of this session you should be able to: Identify symptoms and signs of heart disease with pregnancy Manage the pregnancy, labour and delivery which is complicated by heart disease Identify the predisposing factors to develop heart failure in cases of heart disease with pregnancy Heart disease with pregnancy History Breathlessness any change in heart rate or rhythm increased tiredness Reduction in exercise tolerance Heart disease with pregnancy Examination Pulse, BP, JVP Heart sounds Ankle and sacral oedema Basal crepitation Heart disease with pregnancy Management Should managed in joint clinic Advised to have a low threshold for reducing physical activities Anticoagulant (heparin) for congenital heart disease and valve replacement. Counselled about foetal risks during pregnancy Heart disease with pregnancy Foetal risks Foetal congenital heart disease Maternal cyanosis -→ foetal hypoxia Iatrogenic prematurity FGR Drug effect ( teratogenicity, growth restriction, foetal loss) Heart disease with pregnancy Labour & Delivery management Spontaneous onset Analgesia Fluid balance Judicious use of oxytocin Elective forceps Prophylactic antibiotics Caesarean section only if obstetrically indicated Ergometrine is contraindicated Heart disease with pregnancy Predisposing factors for heart failure Respiratory infection, UTI Anaemia Use of steroids Tocolytics Multiple gestations Hypertension Arrythmia Pain related stress Fluid overload Heart disease with pregnancy Pregnancy is contraindicated in: Pulmonary hypertension Aortic root diameter > 4.5 cm Severe aortic or mitral stenosis Cardiomyopathy with ejection fraction < 30 Coarctation of the aorta Thank you