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In situations when gestation carries a significant fetal or maternal risk, it may be appropriate to terminate the pregnancy. The safest time for termination is during the first trimester. Abortions may be induced by medication or performed surgically. This chapter…
High-Risk Patient Populations The highest-risk patients are those with pulmonary hypertension and those with prior peripartum cardiomyopathy. The American College of Cardiology recommendations for women with adult congenital heart disease are as follows: 1. Women of childbearing potential with congenital…
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Over the past few years, the coronavirus disease 2019 (COVID-19) pandemic has affected nearly every aspect of human life, including, of course, health care. For expecting women, the normal anxiety of pregnancy has been heightened by concern over the possible…
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Assessing the risk posed by pregnancy, for both the mother and baby, is an essential component of caring for women with cardiac disease who are considering becoming pregnant as well as for those who are already pregnant. This chapter explores…
Need for Maternal Cardiac Care Programs A maternal cardiac care program requires the marshalling of significant resources, particularly in terms of personnel, space, and equipment. To justify these resources, we advise estimating the number of patients in need of such…
Aortic Dissection For the expectant mother, there is an increased risk of aortic dissection because of the histologic and hemodynamic changes that occur during pregnancy. Histologic changes in the aortic wall include fragmentation of the reticulum fibers, diminished mucopolysaccharides, and…