Pregnancy in women with high-risk cardiovascular disease

Abstract

 The number of pregnancies complicated with cardiovascular disease is increasing due to the improved prognosis of patients with congenital heart disease; the increased number of diseases diagnosed at a young age by genetic examination, such as channelopathy and the increased number of advanced maternal age pregnancies. Through the experience of pregnancy and childbirth, maternal hemodynamics change dynamically, and the risk of cardiovascular complications increases. Therefore, professional involvement is recommended from the time of preconception counseling.

 In the clinical management of pregnancy with cardiovascular disease, we will attempt to prevent complications and make an early diagnosis by knowledge of the changes and timing of maternal hemodynamics. In addition, although maternal safety is the highest priority in principle, we should become knowledgeable of teratogenicity and fetal toxicity in maternal drug treatment and the effects of fetal exposure and contrast media use in radiological examinations, and carry out appropriate examinations, as well as carrying out treatments during pregnancy. About 10% of maternal deaths in Japan are caused by cardiovascular disease. Thus, team medical care, in which obstetrics, cardiology and other related departments cooperate, is essential in perinatal medical care in high-risk cases.