• Life-threatening conditions in pregnant’s with cardiovascular pathology: multidisciplinary approach 

Life-threatening conditions in pregnant’s with cardiovascular pathology: multidisciplinary approach 

PERINATOLOGIYA I PEDIATRIYA.2016.1(65):18-21;doi 10.15574/PP.2016.65.18 

Life-threatening conditions in pregnant's with cardiovascular pathology: multidisciplinary approach 

Lazoryshynez V. V., Siromakha S. O., Rudenko K. V., Prokopovych L. M., Davydova Yu.V., Limanska A. Yu.

SI «Amosov National Institute of Cardiovascular Surgery NAMS of Ukraine», Kyiv, Ukraine

SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv, Ukraine 

Purpose — to reduce maternal and infant mortality and morbidity, applying a multidisciplinary approach to the treatment of pregnant women with life-threatening heart disease. 

Patients and methods. Pregnant women (n=29) with cardiac pathology, which were assisted during 2013–2015 in SI «Amosov National Institute of Cardiovascular Surgery NAMS of Ukraine» and SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine». 

Results. All pregnant women were divided into three groups: patients, requiring cardiac emergency care (n=10); patients, who cardiac surgery care is provided in conventionally planed (n=11); patients, potentially not require cardiac care, but require multidisciplinary supervision (n=8). In 5 patients performed cardiac surgery using CAPB. In 7 patients with rheumatic heart disease and mitral stenosis III–IV degree (class III–IV WHO) was performed transventricular mitral commissurotomy without the use of cardiopulmonary bypass (CAPB). 8 Cesarean section were performed in women who belonged to Class IV for the modified classification WHO. In two patients with aortic coarctation performed endovascular stenting narrowed region of the aorta, in 6 cases performed surgical treatment of arrhythmias. 

Conclusions. Pregnant women with cardiac pathology requiring intersectoral cooperation obstetrician, cardiologists and cardiac surgeons. Multidisciplinary care to pregnant women with special needs greatly reduces the risk of death and disability of mothers and children, subject to stratification of cardiovascular risk. Special attention required pregnant women with life-threatening conditions, which are subject to emergency or urgent cardiac surgery. 

Key words: pregnancy, congenital heart disease, acquired heart disease, emergency cardiology, obstetric cardiology. 


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