Nature reviews cardiology, 2020-11, Vol.17 (11), p.718-731
2020
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Details
- Autor(en) / Beteiligte
- Titel
- Pregnancy and cardiovascular disease
- Ist Teil von
- Nature reviews cardiology, 2020-11, Vol.17 (11), p.718-731
- Ort / Verlag
- England
- Erscheinungsjahr
- 2020
- Quelle
- MEDLINE
- Beschreibungen/Notizen
- 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.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 1759-5002eISSN: 1759-5010DOI: 10.1038/s41569-020-0390-zTitel-ID: cdi_crossref_primary_10_1038_s41569_020_0390_z
- Format
- –
- Schlagworte
- Acute Coronary Syndrome - diagnosis, Acute Coronary Syndrome - physiopathology, Acute Coronary Syndrome - therapy, Aneurysm, Dissecting - diagnosis, Aneurysm, Dissecting - physiopathology, Aneurysm, Dissecting - 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, Cardiovascular Physiological Phenomena, Diabetes, Gestational - diagnosis, Diabetes, Gestational - metabolism, Diabetes, Gestational - therapy, Disease Progression, Endocarditis - diagnosis, Endocarditis - physiopathology, Endocarditis - therapy, Female, Humans, Hypertension - physiopathology, Hypertension, Pregnancy-Induced - diagnosis, Hypertension, Pregnancy-Induced - drug therapy, Hypertension, Pregnancy-Induced - physiopathology, 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 - physiology, Pregnancy Complications, Cardiovascular - diagnosis, Pregnancy Complications, Cardiovascular - physiopathology, 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