Abstract
Cardiovascular disease (CVD) in pregnancy includes congenital heart disease, acquired heart disease, and myocardial diseases. Although CVD affects only 1–4% of pregnancies in the United States, maternal CVD is the major cause of nonobstetric maternal mortality. Hypertensive disorders occur in 6–8% of all pregnancies and contribute to CVD in pregnancy. Advancing maternal age has increased the incidence of acquired heart disease complicating pregnancy. Congenital heart disease is now the most common form of CVD seen in pregnancy in the United States and Western Europe, accounting for about 80% of CVD cases and 20% of maternal deaths. In developing countries, rheumatic heart disease remains the most common cause (60–90%) of CVD in pregnancy. The hemodynamic adaptations of the maternal cardiovascular system to pregnancy and labor and delivery increase the pregnancy-associated risks in women with preexisting cardiomyopathy, arrhythmia, aortopathy, and valvular and congenital heart disease. Hypertension in pregnancy and peripartum cardiomyopathy are acquired disorders related to pregnancy. Proper risk assessment, prepregnancy counseling, and management of pregnancy in women with preexisting and acquired cardiovascular disease are best performed with a multidisciplinary team.
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References
Weiss BM, von Segesser LK, Alon E, Seifert B, Turina MI. Outcome of cardiovascular surgery and pregnancy: a systematic review of the period 1984–1996. Am J Obstet Gynecol. 1998;179:1643–53.
Peters RM, Flack JM. Hypertensive disorders of pregnancy. J Obstet Gynecol Neonatal Nurs. 2004;33:209–20.
Creanga AA, Berg CJ, Syverson C, Seed K, Bruce FC, Callaghan WM. Pregnancy-related mortality in the United States, 2006–2010. Obstet Gynecol. 2015;125:5–12.
Al-Foudri H, Kevelighan E, Catling S. CEMACH 2003–5 saving mothers‘ lives: lessons for anaesthetists. Contin Educ Anaesth Crit Care Pain. 2010;10:81–7.
Nevo O, Soustiel JF, Thaler I. Maternal cerebral blood flow during normal pregnancy: a cross-sectional study. Am J Obstet Gynecol. 2010;203:475.e1–6.
Khairy P, Ionescu-Ittu R, Mackie AS, Abrahamowicz M, Pilote L, Marelli AJ. Changing mortality in congenital heart disease. J Am Coll Cardiol. 2010;56:1149–57.
Confidential Enquiry into Maternal and Child Health. Why mothers die 2000–2002—executive summary and key findings—the sixth report of confidential enquiries into maternal deaths in the United Kingdom. London, UK: RCOG Press; 2004.
Siu SC, Sermer M, Colman JM, et al. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation. 2001;104:515–21.
Stangl V, Schad J, Gossing G, Borges A, Baumann G, Stangl K. Maternal heart disease and pregnancy outcome: a single-centre experience. Eur J Heart Fail. 2008;10:855–60.
Chapman AB, Abraham WT, Zamudio S, et al. Temporal relationships between hormonal and hemodynamic changes in early human pregnancy. Kidney Int. 1998;54:2056–63.
Trudinger B. Fetal-placental circulation and placentation in normal and hypertensive pregnancies. In: Jacobsen H, Striker G, Klahr S, editors. The principles and practice of nephrology, 2nd ed. 1995. p. 431–5.
August P, Lenz T, Ales KL, et al. Longitudinal study of the renin-angiotensin-aldosterone system in hypertensive pregnant women: deviations related to the development of superimposed preeclampsia. Am J Obstet Gynecol. 1990;163:1612–21.
Sealey JE, Itskovitz-Eldor J, Rubattu S, et al. Estradiol- and progesterone-related increases in the renin-aldosterone system: studies during ovarian stimulation and early pregnancy. J Clin Endocrinol Metab. 1994;79:258–64.
Weiner CP, Thompson LP. Nitric oxide and pregnancy. Semin Perinatol. 1997;21:367–80.
Knock GA, Poston L. Bradykinin-mediated relaxation of isolated maternal resistance arteries in normal pregnancy and preeclampsia. Am J Obstet Gynecol. 1996;175:1668–74.
Pritchard JA. Changes in the blood volume during pregnancy and delivery. Anesthesiology. 1965;26:393–9.
Meah VL, Cockcroft JR, Backx K, Shave R, Stohr EJ. Cardiac output and related haemodynamics during pregnancy: a series of meta-analyses. Heart. 2016;102:518–26.
Grindheim G, Estensen ME, Langesaeter E, Rosseland LA, Toska K. Changes in blood pressure during healthy pregnancy: a longitudinal cohort study. J Hypertens. 2012;30:342–50.
Hermida RC, Ayala DE, Mojon A, Iglesias M. High sensitivity test for the early diagnosis of gestational hypertension and preeclampsia. II. Circadian blood pressure variability in health and hypertensive pregnant women. J Perinat Med. 1997;25:153–67.
MacGillivray I, Rose GA, Rowe B. Blood pressure survey in pregnancy. Clin Sci. 1969;37:395–407.
Lang RM, Pridjian G, Feldman T, Neumann A, Lindheimer M, Borow KM. Left ventricular mechanics in preeclampsia. Am Heart J. 1991;121:1768–75.
Kametas NA, McAuliffe F, Krampl E, Chambers J, Nicolaides KH. Maternal cardiac function in twin pregnancy. Obstet Gynecol. 2003;102:806–15.
Froen JF, Moyland RA, Saugstad OD, Stray-Pedersen B. Maternal health in sudden intrauterine unexplained death: do urinary tract infections protect the fetus? Obstet Gynecol. 2002;100:909–15.
Robson SC, Dunlop W, Moore M, Hunter S. Combined Doppler and echocardiographic measurement of cardiac output: theory and application in pregnancy. Br J Obstet Gynaecol. 1987;94:1014–27.
Campbell DM, MacGillivray I. Comparison of maternal response in first and second pregnancies in relation to baby weight. J Obstet Gynaecol Br Commonw. 1972;79:684–93.
Balci A, Sollie-Szarynska KM, van der Bijl AG, et al. Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease. Heart. 2014;100:1373–81.
Siu SC, Colman JM, Sorensen S, et al. Adverse neonatal and cardiac outcomes are more common in pregnant women with cardiac disease. Circulation. 2002;105:2179–84.
Roos-Hesselink JW, Ruys TP, Stein JI, et al. Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology. Eur Heart J. 2013;34:657–65.
European Society of Gynecology, Association for European Paediatric Cardiology, German Society for Gender Medicine, et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:3147–97.
Balint OH, Siu SC, Mason J, et al. Cardiac outcomes after pregnancy in women with congenital heart disease. Heart. 2010;96:1656–61.
Curtis SL, Marsden-Williams J, Sullivan C, et al. Current trends in the management of heart disease in pregnancy. Int J Cardiol. 2009;133:62–9.
Drenthen W, Boersma E, Balci A, et al. Predictors of pregnancy complications in women with congenital heart disease. Eur Heart J. 2010;31:2124–32.
Ford AA, Wylie BJ, Waksmonski CA, Simpson LL. Maternal congenital cardiac disease: outcomes of pregnancy in a single tertiary care center. Obstet Gynecol. 2008;112:828–33.
Khairy P, Ouyang DW, Fernandes SM, Lee-Parritz A, Economy KE, Landzberg MJ. Pregnancy outcomes in women with congenital heart disease. Circulation. 2006;113:517–24.
Thorne S, MacGregor A, Nelson-Piercy C. Risks of contraception and pregnancy in heart disease. Heart. 2006;92:1520–5.
Thorne S, Nelson-Piercy C, MacGregor A, et al. Pregnancy and contraception in heart disease and pulmonary arterial hypertension. J Fam Plann Reprod Health Care. 2006;32:75–81.
Hameed A, Karaalp IS, Tummala PP, et al. The effect of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol. 2001;37:893–9.
Bedard E, Dimopoulos K, Gatzoulis MA. Has there been any progress made on pregnancy outcomes among women with pulmonary arterial hypertension? Eur Heart J. 2009;30:256–65.
Presbitero P, Somerville J, Stone S, Aruta E, Spiegelhalter D, Rabajoli F. Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. Circulation. 1994;89:2673–6.
Simonneau G, Gatzoulis MA, Adatia I, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2013;62:D34–41.
Miller VM, Aarhus LL, Vanhoutte PM. Modulation of endothelium-dependent responses by chronic alterations of blood flow. Am J Physiol. 1986;251:H520–7.
Saha A, Balakrishnan KG, Jaiswal PK, et al. Prognosis for patients with Eisenmenger syndrome of various aetiology. Int J Cardiol. 1994;45:199–207.
Hopkins WE. The remarkable right ventricle of patients with Eisenmenger syndrome. Coron Artery Dis. 2005;16:19–25.
Hopkins WE, Waggoner AD. Severe pulmonary hypertension without right ventricular failure: the unique hearts of patients with Eisenmenger syndrome. Am J Cardiol. 2002;89:34–8.
Granton JT, Rabinovitch M. Pulmonary arterial hypertension in congenital heart disease. Cardiol Clin. 2002;20:441–57. vii
Diller GP, Dimopoulos K, Broberg CS, et al. Presentation, survival prospects, and predictors of death in Eisenmenger syndrome: a combined retrospective and case-control study. Eur Heart J. 2006;27:1737–42.
Perloff JK, Marelli A. Perloff’s clinical recognition of congenital heart disease. 6th ed. Philadelphia: Saunders; 2012.
Schmaltz AA, Neudorf U, Winkler UH. Outcome of pregnancy in women with congenital heart disease. Cardiol Young. 1999;9:88–96.
Zuber M, Gautschi N, Oechslin E, Widmer V, Kiowski W, Jenni R. Outcome of pregnancy in women with congenital shunt lesions. Heart. 1999;81:271–5.
Reller MD, Strickland MJ, Riehle-Colarusso T, Mahle WT, Correa A. Prevalence of congenital heart defects in metropolitan Atlanta, 1998–2005. J Pediatr. 2008;153:807–13.
Schwedler G, Lindinger A, Lange PE, et al. Frequency and spectrum of congenital heart defects among live births in Germany : a study of the Competence Network for Congenital Heart Defects. Clin Res Cardiol. 2011;100:1111–7.
van der Linde D, Konings EE, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;58:2241–7.
Attenhofer Jost CH, Connolly HM, Danielson GK, et al. Sinus venosus atrial septal defect: long-term postoperative outcome for 115 patients. Circulation. 2005;112:1953–8.
Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–900.
Gersony WM, Hayes CJ, Driscoll DJ, et al. Bacterial endocarditis in patients with aortic stenosis, pulmonary stenosis, or ventricular septal defect. Circulation. 1993;87:I121–6.
Korenberg JR, Bradley C, Disteche CM. Down syndrome: molecular mapping of the congenital heart disease and duodenal stenosis. Am J Hum Genet. 1992;50:294–302.
Agopian AJ, Moulik M, Gupta-Malhotra M, Marengo LK, Mitchell LE. Descriptive epidemiology of non-syndromic complete atrioventricular canal defects. Paediatr Perinat Epidemiol. 2012;26:515–24.
Vahanian A, Baumgartner H, Bax J, et al. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007;28:230–68.
Drenthen W, Pieper PG, van der Tuuk K, et al. Cardiac complications relating to pregnancy and recurrence of disease in the offspring of women with atrioventricular septal defects. Eur Heart J. 2005;26:2581–7.
Brown ML, Burkhart HM, Connolly HM, et al. Coarctation of the aorta: lifelong surveillance is mandatory following surgical repair. J Am Coll Cardiol. 2013;62:1020–5.
Stewart AB, Ahmed R, Travill CM, Newman CG. Coarctation of the aorta life and health 20-44 years after surgical repair. Br Heart J. 1993;69:65–70.
Wong SC, Burgess T, Cheung M, Zacharin M. The prevalence of turner syndrome in girls presenting with coarctation of the aorta. J Pediatr. 2014;164:259–63.
Rocchini AP, Emmanouilides GC. Moss and Adams heart disease in infants, children, and adolescents. 5th ed. Baltimore: Williams & Wilkins; 1995.
Samanek M, Slavik Z, Zborilova B, Hrobonova V, Voriskova M, Skovranek J. Prevalence, treatment, and outcome of heart disease in live-born children: a prospective analysis of 91,823 live-born children. Pediatr Cardiol. 1989;10:205–11.
Stephensen SS, Sigfusson G, Eiriksson H, et al. Congenital cardiac malformations in Iceland from 1990 through 1999. Cardiol Young. 2004;14:396–401.
Keith JD, Rowe RD, Vlad P. Heart disease in infancy and childhood. 3rd ed. New York: MacMillan; 1978.
Koretzky ED, Moller JH, Korns ME, Schwartz CJ, Edwards JE. Congenital pulmonary stenosis resulting from dysplasia of valve. Circulation. 1969;40:43–53.
Baumgartner H, Bonhoeffer P, De Groot NM, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J. 2010;31:2915–57.
Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118:e714–833.
Hayes CJ, Gersony WM, Driscoll DJ, et al. Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis. Circulation. 1993;87:I28–37.
Drenthen W, Pieper PG, Roos-Hesselink JW, et al. Non-cardiac complications during pregnancy in women with isolated congenital pulmonary valvar stenosis. Heart. 2006;92:1838–43.
Presbitero P, Prever SB, Brusca A. Interventional cardiology in pregnancy. Eur Heart J. 1996;17:182–8.
Greutmann M, Von Klemperer K, Brooks R, Peebles D, O’Brien P, Walker F. Pregnancy outcome in women with congenital heart disease and residual haemodynamic lesions of the right ventricular outflow tract. Eur Heart J. 2010;31:1764–70.
Correa-Villasenor A, Ferencz C, Neill CA, Wilson PD, Boughman JA. Ebstein’s malformation of the tricuspid valve: genetic and environmental factors. The Baltimore-Washington Infant Study Group Teratology. 1994;50:137–47.
Lupo PJ, Langlois PH, Mitchell LE. Epidemiology of Ebstein anomaly: prevalence and patterns in Texas, 1999–2005. Am J Med Genet A. 2011;155A:1007–14.
Pradat P, Francannet C, Harris JA, Robert E. The epidemiology of cardiovascular defects, Part I: a study based on data from three large registries of congenital malformations. Pediatr Cardiol. 2003;24:195–221.
Attenhofer Jost CH, Connolly HM, O‘Leary PW, Warnes CA, Tajik AJ, Seward JB. Left heart lesions in patients with Ebstein anomaly. Mayo Clin Proc. 2005;80:361–8.
Attenhofer Jost CH, Connolly HM, Dearani JA, Edwards WD, Danielson GK. Ebstein‘s anomaly. Circulation. 2007;115:277–85.
Connolly HM, Warnes CA. Ebstein‘s anomaly: outcome of pregnancy. J Am Coll Cardiol. 1994;23:1194–8.
Donnelly JE, Brown JM, Radford DJ. Pregnancy outcome and Ebstein‘s anomaly. Br Heart J. 1991;66:368–71.
Centers for Disease Control and Prevention. Improved national prevalence estimates for 18 selected major birth defects—United States, 1999–2001. MMWR Morb Mortal Wkly Rep. 2006;54:1301–5.
Report of the New England Regional Infant Cardiac Program. Pediatrics. 1980;65:375–461.
Bhat AH, Kehl DW, Tacy TA, Moon-Grady AJ, Hornberger LK. Diagnosis of tetralogy of Fallot and its variants in the late first and early second trimester: details of initial assessment and comparison with later fetal diagnosis. Echocardiography. 2013;30:81–7.
Al Habib HF, Jacobs JP, Mavroudis C, et al. Contemporary patterns of management of tetralogy of Fallot: data from the Society of Thoracic Surgeons Database. Ann Thorac Surg. 2010;90:813–9; discussion 819–20
Veldtman GR, Connolly HM, Grogan M, Ammash NM, Warnes CA. Outcomes of pregnancy in women with tetralogy of Fallot. J Am Coll Cardiol. 2004;44:174–80.
Wernovsky G. Transposition of the great arteries. In: Allen HD, Shaddy RE, Driscoll DJ, Feltes TF, editors. Moss and Adams’ heart disease in infants, children, and adolescents: including the fetus and young adult. 7th ed. Philadelphia: Wolters Kluwer Health/Lipincott Williams & Wilkins; 2008.
Buch J, Wennevold A, Jacobsen JR, Hvid-Jacobsen K, Lauridsen P. Long-term follow-up of right ventricular function after Mustard operation for transposition of the great arteries. Scand J Thorac Cardiovasc Surg. 1988;22:197–202.
Derrick GP, Josen M, Vogel M, Henein MY, Shinebourne EA, Redington AN. Abnormalities of right ventricular long axis function after atrial repair of transposition of the great arteries. Heart. 2001;86:203–6.
Fulton DR, Fyler DC. D-Transposition of the great arteries. In: Keane JF, Lock JE, Fyler DC, editors. Nadas’ pediatric cardiology. 2nd ed. Philadelphia: Saunders Elsevier; 2001.
Hutter PA, Kreb DL, Mantel SF, Hitchcock JF, Meijboom EJ, Bennink GB. Twenty-five years’ experience with the arterial switch operation. J Thorac Cardiovasc Surg. 2002;124:790–7.
Legendre A, Losay J, Touchot-Kone A, et al. Coronary events after arterial switch operation for transposition of the great arteries. Circulation. 2003;108(Suppl 1):II186–90.
Schwartz ML, Gauvreau K, del Nido P, Mayer JE, Colan SD. Long-term predictors of aortic root dilation and aortic regurgitation after arterial switch operation. Circulation. 2004;110:II128–32.
Ploeg M, Drenthen W, van Dijk A, Pieper PG. Successful pregnancy after an arterial switch procedure for complete transposition of the great arteries. BJOG. 2006;113:243–4.
Tobler D, Fernandes SM, Wald RM, et al. Pregnancy outcomes in women with transposition of the great arteries and arterial switch operation. Am J Cardiol. 2010;106:417–20.
Cataldo S, Doohan M, Rice K, Trinder J, Stuart AG, Curtis SL. Pregnancy following Mustard or Senning correction of transposition of the great arteries: a retrospective study. BJOG. 2016;123:807–13.
Horer J, Schreiber C, Cleuziou J, et al. Improvement in long-term survival after hospital discharge but not in freedom from reoperation after the change from atrial to arterial switch for transposition of the great arteries. J Thorac Cardiovasc Surg. 2009;137:347–54.
Ferencz C, Rubin JD, McCarter RJ, et al. Congenital heart disease: prevalence at livebirth. The Baltimore-Washington Infant Study. Am J Epidemiol. 1985;121:31–6.
Samanek M, Voriskova M. Congenital heart disease among 815,569 children born between 1980 and 1990 and their 15-year survival: a prospective Bohemia survival study. Pediatr Cardiol. 1999;20:411–7.
Hornung TS, Calder L. Congenitally corrected transposition of the great arteries. Heart. 2010;96:1154–61.
Warnes CA. Transposition of the great arteries. Circulation. 2006;114:2699–709.
Therrien J, Barnes I, Somerville J. Outcome of pregnancy in patients with congenitally corrected transposition of the great arteries. Am J Cardiol. 1999;84:820–4.
Connolly HM, Grogan M, Warnes CA. Pregnancy among women with congenitally corrected transposition of great arteries. J Am Coll Cardiol. 1999;33:1692–5.
Fontan F, Baudet E. Surgical repair of tricuspid atresia. Thorax. 1971;26:240–8.
Gewillig M. The Fontan circulation. Heart. 2005;91:839–46.
Driscoll DJ, Offord KP, Feldt RH, Schaff HV, Puga FJ, Danielson GK. Five- to fifteen-year follow-up after Fontan operation. Circulation. 1992;85:469–96.
Khairy P, Fernandes SM, Mayer JE Jr, et al. Long-term survival, modes of death, and predictors of mortality in patients with Fontan surgery. Circulation. 2008;117:85–92.
Elkayam U, Ostrzega E, Shotan A, Mehra A. Cardiovascular problems in pregnant women with the Marfan syndrome. Ann Intern Med. 1995;123:117–22.
Manalo-Estrella P, Barker AE. Histopathologic findings in human aortic media associated with pregnancy. Arch Pathol. 1967;83:336–41.
Meijboom LJ, Nollen GJ, Merchant N, et al. Frequency of coronary ostial aneurysms after aortic root surgery in patients with the Marfan syndrome. Am J Cardiol. 2002;89:1135–8.
Judge DP, Dietz HC. Marfan’s syndrome. Lancet. 2005;366:1965–76.
Ramirez F, Godfrey M, Lee B. Marfan syndrome and related disorders. In: Scriver CR, Beaudet AL, Sly WS, Childs B, Valle D, Kinzler KW, editors. The metabolic and molecular basis of inherited disease. New York: McGraw Hill; 1995.
Collod-Beroud G, Le Bourdelles S, Ades L, et al. Update of the UMD-FBN1 mutation database and creation of an FBN1 polymorphism database. Hum Mutat. 2003;22:199–208.
Loeys BL, Dietz HC, Braverman AC, et al. The revised Ghent nosology for the Marfan syndrome. J Med Genet. 2010;47:476–85.
Radonic T, de Witte P, Groenink M, et al. Critical appraisal of the revised Ghent criteria for diagnosis of Marfan syndrome. Clin Genet. 2011;80:346–53.
Pyeritz RE. Maternal and fetal complications of pregnancy in the Marfan syndrome. Am J Med. 1981;71:784–90.
Therrien J, Gatzoulis M, Graham T, et al. Canadian Cardiovascular Society consensus conference 2001 update: recommendations for the management of adults with congenital heart disease—Part II. Can J Cardiol. 2001;17:1029–50.
Rossiter JP, Repke JT, Morales AJ, Murphy EA, Pyeritz RE. A prospective longitudinal evaluation of pregnancy in the Marfan syndrome. Am J Obstet Gynecol. 1995;173:1599–606.
Deanfield J, Thaulow E, Warnes C, et al. Management of grown up congenital heart disease. Eur Heart J. 2003;24:1035–84.
Immer FF, Bansi AG, Immer-Bansi AS, et al. Aortic dissection in pregnancy: analysis of risk factors and outcome. Ann Thorac Surg. 2003;76:309–14.
Meijboom LJ, Vos FE, Timmermans J, Boers GH, Zwinderman AH, Mulder BJ. Pregnancy and aortic root growth in the Marfan syndrome: a prospective study. Eur Heart J. 2005;26:914–20.
Hiratzka LF, Bakris GL, Beckman JA, et al. ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation. 2010;121:e266–369.
Bonow RO, Carabello BA, Chatterjee K, et al. Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2008;118:e523–661.
Lipscomb KJ, Smith JC, Clarke B, Donnai P, Harris R. Outcome of pregnancy in women with Marfan’s syndrome. Br J Obstet Gynaecol. 1997;104:201–6.
Doyle JJ, Doyle AJ, Wilson NK, et al. A deleterious gene-by-environment interaction imposed by calcium channel blockers in Marfan syndrome. Elife. 2015;4.
Parry AJ, Westaby S. Cardiopulmonary bypass during pregnancy. Ann Thorac Surg. 1996;61:1865–9.
Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol. 2010;55:2789–800.
Tzemos N, Therrien J, Yip J, et al. Outcomes in adults with bicuspid aortic valves. JAMA. 2008;300:1317–25.
Michelena HI, Khanna AD, Mahoney D, et al. Incidence of aortic complications in patients with bicuspid aortic valves. JAMA. 2011;306:1104–12.
Shimada I, Rooney SJ, Pagano D, et al. Prediction of thoracic aortic aneurysm expansion: validation of formulae describing growth. Ann Thorac Surg. 1999;67:1968–70; discussion 1979–80
Anderson RA, Fineron PW. Aortic dissection in pregnancy: importance of pregnancy-induced changes in the vessel wall and bicuspid aortic valve in pathogenesis. Br J Obstet Gynaecol. 1994;101:1085–8.
Gunther DF, Eugster E, Zagar AJ, Bryant CG, Davenport ML, Quigley CA. Ascertainment bias in Turner syndrome: new insights from girls who were diagnosed incidentally in prenatal life. Pediatrics. 2004;114:640–4.
Bondy CA, Turner Syndrome Study G. Care of girls and women with Turner syndrome: a guideline of the Turner Syndrome Study Group. J Clin Endocrinol Metab. 2007;92:10–25.
Nielsen J, Wohlert M. Chromosome abnormalities found among 34,910 newborn children: results from a 13-year incidence study in Arhus, Denmark. Hum Genet. 1991;87:81–3.
Cramer JW, Bartz PJ, Simpson PM, Zangwill SD. The spectrum of congenital heart disease and outcomes after surgical repair among children with Turner syndrome: a single-center review. Pediatr Cardiol. 2014;35:253–60.
Gotzsche CO, Krag-Olsen B, Nielsen J, Sorensen KE, Kristensen BO. Prevalence of cardiovascular malformations and association with karyotypes in Turner’s syndrome. Arch Dis Child. 1994;71:433–6.
Sachdev V, Matura LA, Sidenko S, et al. Aortic valve disease in Turner syndrome. J Am Coll Cardiol. 2008;51:1904–9.
Carlson M, Airhart N, Lopez L, Silberbach M. Moderate aortic enlargement and bicuspid aortic valve are associated with aortic dissection in Turner syndrome: report of the international turner syndrome aortic dissection registry. Circulation. 2012;126:2220–6.
Lin AE, Lippe B, Rosenfeld RG. Further delineation of aortic dilation, dissection, and rupture in patients with Turner syndrome. Pediatrics. 1998;102:e12.
Matura LA, Ho VB, Rosing DR, Bondy CA. Aortic dilatation and dissection in Turner syndrome. Circulation. 2007;116:1663–70.
Karnis MF, Zimon AE, Lalwani SI, Timmreck LS, Klipstein S, Reindollar RH. Risk of death in pregnancy achieved through oocyte donation in patients with Turner syndrome: a national survey. Fertil Steril. 2003;80:498–501.
Avila WS, Rossi EG, Ramires JA, et al. Pregnancy in patients with heart disease: experience with 1,000 cases. Clin Cardiol. 2003;26:135–42.
Diao M, Kane A, Ndiaye MB, et al. Pregnancy in women with heart disease in sub-Saharan Africa. Arch Cardiovasc Dis. 2011;104:370–4.
Kuklina E, Callaghan W. Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995–2006. BJOG. 2011;118:345–52.
Siu SC, Sermer M, Harrison DA, et al. Risk and predictors for pregnancy-related complications in women with heart disease. Circulation. 1997;96:2789–94.
Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:e57–185.
Chikwe J, Chiang YP, Egorova NN, Itagaki S, Adams DH. Survival and outcomes following bioprosthetic vs mechanical mitral valve replacement in patients aged 50 to 69 years. JAMA. 2015;313:1435–42.
McClure RS, McGurk S, Cevasco M, et al. Late outcomes comparison of nonelderly patients with stented bioprosthetic and mechanical valves in the aortic position: a propensity-matched analysis. J Thorac Cardiovasc Surg. 2014;148:1931–9.
Chambers CE, Clark SL. Cardiac surgery during pregnancy. Clin Obstet Gynecol. 1994;37:316–23.
Pomini F, Mercogliano D, Cavalletti C, Caruso A, Pomini P. Cardiopulmonary bypass in pregnancy. Ann Thorac Surg. 1996;61:259–68.
Becker RM. Intracardiac surgery in pregnant women. Ann Thorac Surg. 1983;36:453–8.
Martin MC, Pernoll ML, Boruszak AN, Jones JW, LoCicero J 3rd. Cesarean section while on cardiac bypass: report of a case. Obstet Gynecol. 1981;57:41S–5S.
Rheumatic fever and rheumatic heart disease. World Health Organ Tech Rep Ser. 2004;923:1–122, back cover.
Selzer A, Cohn KE. Natural history of mitral stenosis: a review. Circulation. 1972;45:878–90.
Zuhlke LJ, Beaton A, Engel ME, et al. Group A Streptococcus, acute rheumatic fever and rheumatic heart disease: epidemiology and clinical considerations. Curr Treat Options Cardiovasc Med. 2017;19:15.
Gewitz MH, Baltimore RS, Tani LY, et al. Revision of the Jones Criteria for the diagnosis of acute rheumatic fever in the era of Doppler echocardiography: a scientific statement from the American Heart Association. Circulation. 2015;131:1806–18.
Marcus RH, Sareli P, Pocock WA, Barlow JB. The spectrum of severe rheumatic mitral valve disease in a developing country. Correlations among clinical presentation, surgical pathologic findings, and hemodynamic sequelae. Ann Intern Med. 1994;120:177–83.
Bland EF, Duckett JT. Rheumatic fever and rheumatic heart disease; a twenty year report on 1000 patients followed since childhood. Circulation. 1951;4:836–43.
Zuhlke L, Engel ME, Karthikeyan G, et al. Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study). Eur Heart J. 2015;36:1115–22.
Watkins DA, Johnson CO, Colquhoun SM, et al. Global, regional, and national burden of rheumatic heart disease, 1990–2015. N Engl J Med. 2017;377:713–22.
Silversides CK, Colman JM, Sermer M, Siu SC. Cardiac risk in pregnant women with rheumatic mitral stenosis. Am J Cardiol. 2003;91:1382–5.
Ruys TP, Roos-Hesselink JW, Hall R, et al. Heart failure in pregnant women with cardiac disease: data from the ROPAC. Heart. 2014;100:231–8.
Elkayam U, Bitar F. Valvular heart disease and pregnancy Part I: Native valves. J Am Coll Cardiol. 2005;46:223–30.
Roberts WC. The congenitally bicuspid aortic valve. A study of 85 autopsy cases. Am J Cardiol. 1970;26:72–83.
Eisenberg LM, Markwald RR. Molecular regulation of atrioventricular valvuloseptal morphogenesis. Circ Res. 1995;77:1–6.
Huntington K, Hunter AG, Chan KL. A prospective study to assess the frequency of familial clustering of congenital bicuspid aortic valve. J Am Coll Cardiol. 1997;30:1809–12.
Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology European Association for Cardio-Thoracic Surgery, Vahanian A, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012;33:2451–96.
Ward C. Clinical significance of the bicuspid aortic valve. Heart. 2000;83:81–5.
Chan KL, Ghani M, Woodend K, Burwash IG. Case-controlled study to assess risk factors for aortic stenosis in congenitally bicuspid aortic valve. Am J Cardiol. 2001;88:690–3.
Silversides CK, Colman JM, Sermer M, Farine D, Siu SC. Early and intermediate-term outcomes of pregnancy with congenital aortic stenosis. Am J Cardiol. 2003;91:1386–9.
Easterling TR, Chadwick HS, Otto CM, Benedetti TJ. Aortic stenosis in pregnancy. Obstet Gynecol. 1988;72:113–8.
Lao TT, Sermer M, MaGee L, Farine D, Colman JM. Congenital aortic stenosis and pregnancy—a reappraisal. Am J Obstet Gynecol. 1993;169:540–5.
Yap SC, Drenthen W, Pieper PG, et al. Risk of complications during pregnancy in women with congenital aortic stenosis. Int J Cardiol. 2008;126:240–6.
Roberts WC, Morrow AG, McIntosh CL, Jones M, Epstein SE. Congenitally bicuspid aortic valve causing severe, pure aortic regurgitation without superimposed infective endocarditis. Analysis of 13 patients requiring aortic valve replacement. Am J Cardiol. 1981;47:206–9.
Pachulski RT, Chan KL. Progression of aortic valve dysfunction in 51 adult patients with congenital bicuspid aortic valve: assessment and follow up by Doppler echocardiography. Br Heart J. 1993;69:237–40.
Remenyi B, Wilson N, Steer A, et al. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease—an evidence-based guideline. Nat Rev Cardiol. 2012;9:297–309.
Dujardin KS, Enriquez-Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ. Mortality and morbidity of aortic regurgitation in clinical practice. A long-term follow-up study. Circulation. 1999;99:1851–7.
John AS, Gurley F, Schaff HV, et al. Cardiopulmonary bypass during pregnancy. Ann Thorac Surg. 2011;91:1191–6.
De Santo LS, Romano G, Della Corte A, et al. Mitral mechanical replacement in young rheumatic women: analysis of long-term survival, valve-related complications, and pregnancy outcomes over a 3707-patient-year follow-up. J Thorac Cardiovasc Surg. 2005;130:13–9.
Vural KM, Ozatik MA, Uncu H, et al. Pregnancy after mechanical mitral valve replacement. J Heart Valve Dis. 2003;12:370–6.
Bourguignon T, Bouquiaux-Stablo AL, Candolfi P, et al. Very long-term outcomes of the Carpentier-Edwards Perimount valve in aortic position. Ann Thorac Surg. 2015;99:831–7.
Badduke BR, Jamieson WR, Miyagishima RT, et al. Pregnancy and childbearing in a population with biologic valvular prostheses. J Thorac Cardiovasc Surg. 1991;102:179–86.
Sbarouni E, Oakley CM. Outcome of pregnancy in women with valve prostheses. Br Heart J. 1994;71:196–201.
El SF, Hassan W, Latroche B, et al. Pregnancy has no effect on the rate of structural deterioration of bioprosthetic valves: long-term 18-year follow up results. J Heart Valve Dis. 2005;14:481–5.
North RA, Sadler L, Stewart AW, McCowan LM, Kerr AR, White HD. Long-term survival and valve-related complications in young women with cardiac valve replacements. Circulation. 1999;99:2669–76.
Lawley CM, Lain SJ, Algert CS, Ford JB, Figtree GA, Roberts CL. Prosthetic heart valves in pregnancy, outcomes for women and their babies: a systematic review and meta-analysis. BJOG. 2015;122:1446–55.
van Hagen IM, Roos-Hesselink JW, Ruys TP, et al. Pregnancy in women with a mechanical heart valve: data of the European Society of Cardiology Registry of Pregnancy and Cardiac Disease (ROPAC). Circulation. 2015;132:132–42.
Vongpatanasin W, Hillis LD, Lange RA. Prosthetic heart valves. N Engl J Med. 1996;335:407–16.
Elkayam U, Singh H, Irani A, Akhter MW. Anticoagulation in pregnant women with prosthetic heart valves. J Cardiovasc Pharmacol Ther. 2004;9:107–15.
D’Souza R, Ostro J, Shah PS, et al. Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis. Eur Heart J. 2017;38:1509–16.
Huttel E, Padberg S, Meister R, Beck E, Schaefer C. Pregnancy outcome of first trimester exposure to the vitamin K antagonist phenprocoumon depends on duration of treatment. Thromb Haemost. 2017;117:870–9.
Chan WS, Anand S, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med. 2000;160:191–6.
Abildgaard U, Sandset PM, Hammerstrom J, Gjestvang FT, Tveit A. Management of pregnant women with mechanical heart valve prosthesis: thromboprophylaxis with low molecular weight heparin. Thromb Res. 2009;124:262–7.
McLintock C, McCowan LM, North RA. Maternal complications and pregnancy outcome in women with mechanical prosthetic heart valves treated with enoxaparin. BJOG. 2009;116:1585–92.
Saeed CR, Frank JB, Pravin M, Aziz RH, Serasheini M, Dominique TG. A prospective trial showing the safety of adjusted-dose enoxaparin for thromboprophylaxis of pregnant women with mechanical prosthetic heart valves. Clin Appl Thromb Hemost. 2011;17:313–9.
Barbour LA, Oja JL, Schultz LK. A prospective trial that demonstrates that dalteparin requirements increase in pregnancy to maintain therapeutic levels of anticoagulation. Am J Obstet Gynecol. 2004;191:1024–9.
Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med. 2013;369:1206–14.
U.S. Food and Drug Administration. FDA Drug Safety Communication: Pradaxa (dabigatran etexilate mesylate) should not be used in patients with mechanical prosthetic heart valves. https://www.fda.gov/Drugs/DrugSafety/ucm332912.htm. Accessed 3 Aug 2018.
Van de Werf F, Brueckmann M, Connolly SJ, et al. A comparison of dabigatran etexilate with warfarin in patients with mechanical heart valves: THE Randomized, phase II study to evaluate the safety and pharmacokinetics of oral dabigatran etexilate in patients after heart valve replacement (RE-ALIGN). Am Heart J. 2012;163:931–937.e1.
Quinn J, Von Klemperer K, Brooks R, Peebles D, Walker F, Cohen H. Use of high intensity adjusted dose low molecular weight heparin in women with mechanical heart valves during pregnancy: a single-center experience. Haematologica. 2009;94:1608–12.
Steinberg ZL, Dominguez-Islas CP, Otto CM, Stout KK, Krieger EV. Maternal and fetal outcomes of anticoagulation in pregnant women with mechanical heart valves. J Am Coll Cardiol. 2017;69:2681–91.
Yinon Y, Siu SC, Warshafsky C, et al. Use of low molecular weight heparin in pregnant women with mechanical heart valves. Am J Cardiol. 2009;104:1259–63.
Caceres-Loriga FM, Perez-Lopez H, Morlans-Hernandez K, et al. Thrombolysis as first choice therapy in prosthetic heart valve thrombosis. A study of 68 patients. J Thromb Thrombolysis. 2006;21:185–90.
Karthikeyan G, Math RS, Mathew N, et al. Accelerated infusion of streptokinase for the treatment of left-sided prosthetic valve thrombosis: a randomized controlled trial. Circulation. 2009;120:1108–14.
Keuleers S, Herijgers P, Herregods MC, et al. Comparison of thrombolysis versus surgery as a first line therapy for prosthetic heart valve thrombosis. Am J Cardiol. 2011;107:275–9.
Nagy A, Denes M, Lengyel M. Predictors of the outcome of thrombolytic therapy in prosthetic mitral valve thrombosis: a study of 62 events. J Heart Valve Dis. 2009;18:268–75.
Ozkan M, Gunduz S, Biteker M, et al. Comparison of different TEE-guided thrombolytic regimens for prosthetic valve thrombosis: the TROIA trial. JACC Cardiovasc Imaging. 2013;6:206–16.
Roudaut R, Lafitte S, Roudaut MF, et al. Management of prosthetic heart valve obstruction: fibrinolysis versus surgery. Early results and long-term follow-up in a single-centre study of 263 cases. Arch Cardiovasc Dis. 2009;102:269–77.
Karthikeyan G, Senguttuvan NB, Joseph J, Devasenapathy N, Bahl VK, Airan B. Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies. Eur Heart J. 2013;34:1557–66.
Ozkan M, Cakal B, Karakoyun S, et al. Thrombolytic therapy for the treatment of prosthetic heart valve thrombosis in pregnancy with low-dose, slow infusion of tissue-type plasminogen activator. Circulation. 2013;128:532–40.
Maron BJ. Hypertrophic cardiomyopathy: a systematic review. JAMA. 2002;287:1308–20.
Sliwa K, Mebazaa A, Hilfiker-Kleiner D, et al. Clinical characteristics of patients from the worldwide registry on peripartum cardiomyopathy (PPCM): EURObservational Research Programme in conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on PPCM. Eur J Heart Fail. 2017;19:1131–41.
Monserrat L, Elliott PM, Gimeno JR, Sharma S, Penas-Lado M, McKenna WJ. Non-sustained ventricular tachycardia in hypertrophic cardiomyopathy: an independent marker of sudden death risk in young patients. J Am Coll Cardiol. 2003;42:873–9.
Spirito P, Rapezzi C, Autore C, et al. Prognosis of asymptomatic patients with hypertrophic cardiomyopathy and nonsustained ventricular tachycardia. Circulation. 1994;90:2743–7.
Yetman AT, Hamilton RM, Benson LN, McCrindle BW. Long-term outcome and prognostic determinants in children with hypertrophic cardiomyopathy. J Am Coll Cardiol. 1998;32:1943–50.
Nienaber CA, Hiller S, Spielmann RP, Geiger M, Kuck KH. Syncope in hypertrophic cardiomyopathy: multivariate analysis of prognostic determinants. J Am Coll Cardiol. 1990;15:948–55.
Demakis JG, Rahimtoola SH, Sutton GC, et al. Natural course of peripartum cardiomyopathy. Circulation. 1971;44:1053–61.
Pearson VL, Rothwell NJ, Toulmond S. Excitotoxic brain damage in the rat induces interleukin-1beta protein in microglia and astrocytes: correlation with the progression of cell death. Glia. 1999;25:311–23.
Elkayam U, Akhter MW, Singh H, et al. Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation. Circulation. 2005;111:2050–5.
Sliwa K, Hilfiker-Kleiner D, Petrie MC, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail. 2010;12:767–78.
Hibbard JU, Lindheimer M, Lang RM. A modified definition for peripartum cardiomyopathy and prognosis based on echocardiography. Obstet Gynecol. 1999;94:311–6.
Forster O, Hilfiker-Kleiner D, Ansari AA, et al. Reversal of IFN-gamma, oxLDL and prolactin serum levels correlate with clinical improvement in patients with peripartum cardiomyopathy. Eur J Heart Fail. 2008;10:861–8.
Hu CL, Li YB, Zou YG, et al. Troponin T measurement can predict persistent left ventricular dysfunction in peripartum cardiomyopathy. Heart. 2007;93:488–90.
Halkein J, Tabruyn SP, Ricke-Hoch M, et al. MicroRNA-146a is a therapeutic target and biomarker for peripartum cardiomyopathy. J Clin Invest. 2013;123:2143–54.
Brar SS, Khan SS, Sandhu GK, et al. Incidence, mortality, and racial differences in peripartum cardiomyopathy. Am J Cardiol. 2007;100:302–4.
Deneux-Tharaux C, Berg C, Bouvier-Colle MH, et al. Underreporting of pregnancy-related mortality in the United States and Europe. Obstet Gynecol. 2005;106:684–92.
Bello N, Rendon ISH, Arany Z. The relationship between pre-eclampsia and peripartum cardiomyopathy: a systematic review and meta-analysis. J Am Coll Cardiol. 2013;62:1715–23.
Homans DC. Peripartum cardiomyopathy. N Engl J Med. 1985;312:1432–7.
Seftel H, Susser M. Maternity and myocardial failure in African women. Br Heart J. 1961;23:43–52.
Kolte D, Khera S, Aronow WS, et al. Temporal trends in incidence and outcomes of peripartum cardiomyopathy in the United States: a nationwide population-based study. J Am Heart Assoc. 2014;3:e001056.
Mielniczuk LM, Williams K, Davis DR, et al. Frequency of peripartum cardiomyopathy. Am J Cardiol. 2006;97:1765–8.
Pearson GD, Veille JC, Rahimtoola S, et al. Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA. 2000;283:1183–8.
Isezuo SA, Abubakar SA. Epidemiologic profile of peripartum cardiomyopathy in a tertiary care hospital. Ethn Dis. 2007;17:228–33.
Sliwa K, Damasceno A, Mayosi BM. Epidemiology and etiology of cardiomyopathy in Africa. Circulation. 2005;112:3577–83.
Sanderson JE, Adesanya CO, Anjorin FI, Parry EH. Postpartum cardiac failure—heart failure due to volume overload? Am Heart J. 1979;97:613–21.
Goland S, Modi K, Hatamizadeh P, Elkayam U. Differences in clinical profile of African-American women with peripartum cardiomyopathy in the United States. J Card Fail. 2013;19:214–8.
Irizarry OC, Levine LD, Lewey J, et al. Comparison of clinical characteristics and outcomes of peripartum cardiomyopathy between African American and non-African American women. JAMA Cardiol. 2017;2:1256–60.
Barasa A, Rosengren A, Sandstrom TZ, Ladfors L, Schaufelberger M. Heart failure in late pregnancy and postpartum: Incidence and long-term mortality in Sweden from 1997 to 2010. J Card Fail. 2017;23:370–8.
Melchiorre K, Sutherland GR, Baltabaeva A, Liberati M, Thilaganathan B. Maternal cardiac dysfunction and remodeling in women with preeclampsia at term. Hypertension. 2011;57:85–93.
Melchiorre K, Sutherland GR, Liberati M, Thilaganathan B. Preeclampsia is associated with persistent postpartum cardiovascular impairment. Hypertension. 2011;58:709–15.
Demakis JG, Rahimtoola SH. Peripartum cardiomyopathy. Circulation. 1971;44:964–8.
Gunderson EP, Croen LA, Chiang V, Yoshida CK, Walton D, Go AS. Epidemiology of peripartum cardiomyopathy: incidence, predictors, and outcomes. Obstet Gynecol. 2011;118:583–91.
Zuspan FP, Rayburn WF. Blood pressure self-monitoring during pregnancy: practical considerations. Am J Obstet Gynecol. 1991;164:2–6.
Felker GM, Jaeger CJ, Klodas E, et al. Myocarditis and long-term survival in peripartum cardiomyopathy. Am Heart J. 2000;140:785–91.
Ntusi NB, Mayosi BM. Aetiology and risk factors of peripartum cardiomyopathy: a systematic review. Int J Cardiol. 2009;131:168–79.
Kao DP, Hsich E, Lindenfeld J. Characteristics, adverse events, and racial differences among delivering mothers with peripartum cardiomyopathy. JACC Heart Fail. 2013;1:409–16.
Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science. 2005;308:1592–4.
Sliwa K, Fett J, Elkayam U. Peripartum cardiomyopathy. Lancet. 2006;368:687–93.
Amos AM, Jaber WA, Russell SD. Improved outcomes in peripartum cardiomyopathy with contemporary. Am Heart J. 2006;152:509–13.
Bdolah Y, Lam C, Rajakumar A, et al. Twin pregnancy and the risk of preeclampsia: bigger placenta or relative ischemia? Am J Obstet Gynecol. 2008;198:428e1–6.
van Spaendonck-Zwarts KY, Posafalvi A, van den Berg MP, et al. Titin gene mutations are common in families with both peripartum cardiomyopathy and dilated cardiomyopathy. Eur Heart J. 2014;35:2165–73.
McNamara DM, Elkayam U, Alharethi R, et al. Clinical outcomes for peripartum cardiomyopathy in North America: results of the IPAC study (Investigations of Pregnancy-Associated Cardiomyopathy). J Am Coll Cardiol. 2015;66:905–14.
Meirhaeghe A, Bauters C, Helbecque N, et al. The human G-protein beta3 subunit C825T polymorphism is associated with coronary artery vasoconstriction. Eur Heart J. 2001;22:845–8.
Schunkert H, Hense HW, Doring A, Riegger GA, Siffert W. Association between a polymorphism in the G protein beta3 subunit gene and lower renin and elevated diastolic blood pressure levels. Hypertension. 1998;32:510–3.
Siffert W. G-protein beta3 subunit 825T allele and hypertension. Curr Hypertens Rep. 2003;5:47–53.
Siffert W, Rosskopf D, Siffert G, et al. Association of a human G-protein beta3 subunit variant with hypertension. Nat Genet. 1998;18:45–8.
Sheppard R, Hsich E, Damp J, et al. GNB3 C825T polymorphism and myocardial recovery in peripartum cardiomyopathy: results of the multicenter investigations of pregnancy-associated cardiomyopathy study. Circ Heart Fail. 2016;9:e002683.
Morales A, Painter T, Li R, et al. Rare variant mutations in pregnancy-associated or peripartum cardiomyopathy. Circulation. 2010;121:2176–82.
Ntusi NB, Wonkam A, Shaboodien G, Badri M, Mayosi BM. Frequency and clinical genetics of familial dilated cardiomyopathy in Cape Town: implications for the evaluation of patients with unexplained cardiomyopathy. S Afr Med J. 2011;101:394–8.
Pearl W. Familial occurrence of peripartum cardiomyopathy. Am Heart J. 1995;129:421–2.
van Spaendonck-Zwarts KY, van Tintelen JP, van Veldhuisen DJ, et al. Peripartum cardiomyopathy as a part of familial dilated cardiomyopathy. Circulation. 2010;121:2169–75.
Cheng VE, Prior DL. Peripartum cardiomyopathy in a previously asymptomatic carrier of Duchenne muscular dystrophy. Heart Lung Circ. 2013;22:677–81.
Politano L, Nigro V, Nigro G, et al. Development of cardiomyopathy in female carriers of Duchenne and Becker muscular dystrophies. JAMA. 1996;275:1335–8.
Ware JS, Li J, Mazaika E, et al. Shared genetic predisposition in peripartum and dilated cardiomyopathies. N Engl J Med. 2016;374:233–41.
Bakre MM, Zhu Y, Yin H, et al. Parathyroid hormone-related peptide is a naturally occurring, protein kinase A-dependent angiogenesis inhibitor. Nat Med. 2002;8:995–1003.
Horne BD, Rasmusson KD, Alharethi R, et al. Genome-wide significance and replication of the chromosome 12p11.22 locus near the PTHLH gene for peripartum cardiomyopathy. Circ Cardiovasc Genet. 2011;4:359–66.
Rasmusson K, Brunisholz K, Budge D, et al. Peripartum cardiomyopathy: post-transplant outcomes from the United Network for Organ Sharing Database. J Heart Lung Transplant. 2012;31:180–6.
Hilfiker-Kleiner D, Kaminski K, Podewski E, et al. A cathepsin D-cleaved 16 kDa form of prolactin mediates postpartum cardiomyopathy. Cell. 2007;128:589–600.
Patten IS, Rana S, Shahul S, et al. Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. Nature. 2012;485:333–8.
Uraizee I, Cheng S, Moslehi J. Reversible cardiomyopathy associated with sunitinib and sorafenib. N Engl J Med. 2011;365:1649–50.
Ng DC, Court NW, dos Remedios CG, Bogoyevitch MA. Activation of signal transducer and activator of transcription (STAT) pathways in failing human hearts. Cardiovasc Res. 2003;57:333–46.
Arany Z, Foo SY, Ma Y, et al. HIF-independent regulation of VEGF and angiogenesis by the transcriptional coactivator PGC-1alpha. Nature. 2008;451:1008–12.
Bajou K, Herkenne S, Thijssen VL, et al. PAI-1 mediates the antiangiogenic and profibrinolytic effects of 16K prolactin. Nat Med. 2014;20:741–7.
Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation. 2011;123:2856–69.
Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350:672–83.
Goland S, Modi K, Bitar F, et al. Clinical profile and predictors of complications in peripartum cardiomyopathy. J Card Fail. 2009;15:645–50.
Kane A, Mbaye M, Ndiaye MB, et al. [Evolution and thromboembolic complications of the idiopathic peripartal cardiomyopathy at Dakar University Hospital: forward-looking study about 33 cases]. J Gynecol Obstet Biol Reprod (Paris). 2010;39:484–9.
Simeon IA. Echocardiographic profile of peripartum cardiomyopathy in a tertiary care hospital in sokoto, Nigeria. Indian Heart J. 2006;58:234–8.
Main EK, McCain CL, Morton CH, Holtby S, Lawton ES. Pregnancy-related mortality in California: causes, characteristics, and improvement opportunities. Obstet Gynecol. 2015;125:938–47.
Lampert MB, Weinert L, Hibbard J, Korcarz C, Lindheimer M, Lang RM. Contractile reserve in patients with peripartum cardiomyopathy and recovered left ventricular function. Am J Obstet Gynecol. 1997;176:189–95.
Pillarisetti J, Kondur A, Alani A, et al. Peripartum cardiomyopathy: predictors of recovery and current state of implantable cardioverter-defibrillator use. J Am Coll Cardiol. 2014;63:2831–9.
Sliwa K, Skudicky D, Bergemann A, Candy G, Puren A, Sareli P. Peripartum cardiomyopathy: analysis of clinical outcome, left ventricular function, plasma levels of cytokines and Fas/APO-1. J Am Coll Cardiol. 2000;35:701–5.
Harper MA, Meyer RE, Berg CJ. Peripartum cardiomyopathy: population-based birth prevalence and 7-year mortality. Obstet Gynecol. 2012;120:1013–9.
Sliwa K, Forster O, Libhaber E, et al. Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. Eur Heart J. 2006;27:441–6.
Murali S, Baldisseri MR. Peripartum cardiomyopathy. Crit Care Med. 2005;33:S340–6.
Veille JC. Peripartum cardiomyopathies: a review. Am J Obstet Gynecol. 1984;148:805–18.
Grewal J, Siu SC, Ross HJ, et al. Pregnancy outcomes in women with dilated cardiomyopathy. J Am Coll Cardiol. 2009;55:45–52.
Elkayam U. Risk of subsequent pregnancy in women with a history of peripartum cardiomyopathy. J Am Coll Cardiol. 2014;64:1629–36.
Desai D, Moodley J, Naidoo D. Peripartum cardiomyopathy: experiences at King Edward VIII Hospital, Durban, South Africa and a review of the literature. Trop Doct. 1995;25:118–23.
American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776–89.
Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol. 2002;100:369–77.
Butters L, Kennedy S, Rubin PC. Atenolol in essential hypertension during pregnancy. BMJ. 1990;301:587–9.
Briggs GG, Freeman RK, Yatte SJ. Drugs in pregnancy and lactation. 8th ed. Philadelphia: Wolters Kluwer; 2008.
Kuzniar J, Skret A, Piela A, Szmigiel Z, Zaczek T. Hemodynamic effects of intravenous hydralazine in pregnant women with severe hypertension. Obstet Gynecol. 1985;66:453–8.
Vink GJ, Moodley J, Philpott RH. Effect of dihydralazine on the fetus in the treatment of maternal hypertension. Obstet Gynecol. 1980;55:519–22.
U.S. National Library of Medicine. Drugs and lactation database (LactMed). https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACTMED. Accessed 1 July 2014.
Iffy L, Lindenthal J, McArdle JJ, Ganesh V. Severe cerebral accidents postpartum in patients taking bromocriptine for milk suppression. Isr J Med Sci. 1996;32:309–12.
Loewe C, Dragovic LJ. Acute coronary artery thrombosis in a postpartum woman receiving bromocriptine. Am J Forensic Med Pathol. 1998;19:258–60.
Bouabdallaoui N, Mouquet F, Lebreton G, Demondion P, Le Jemtel TH, Ennezat PV. Current knowledge and recent development on management of peripartum cardiomyopathy. Eur Heart J Acute Cardiovasc Care. 2017;6:359–66.
Turkalj I, Braun P, Krupp P. Surveillance of bromocriptine in pregnancy. JAMA. 1982;247:1589–91.
U.S. Government Publishing Office. Sandoz Pharmaceuticals Corp.; Bromocriptine mesylate (Parlodel); Withdrawal of approval of the indication for the prevention of physiological lactation. Fed Regist. 1995;60:3404–5.
Sliwa K, Blauwet L, Tibazarwa K, et al. Evaluation of bromocriptine in the treatment of acute severe peripartum cardiomyopathy: a proof-of-concept pilot study. Circulation. 2010;121:1465–73.
Hilfiker-Kleiner D, Haghikia A, Berliner D, et al. Bromocriptine for the treatment of peripartum cardiomyopathy: a multicentre randomized study. Eur Heart J. 2017;38:2671–9.
Hilfiker-Kleiner D, Meyer GP, Schieffer E, et al. Recovery from postpartum cardiomyopathy in 2 patients by blocking prolactin release with bromocriptine. J Am Coll Cardiol. 2007;50:2354–5.
Jahns BG, Stein W, Hilfiker-Kleiner D, Pieske B, Emons G. Peripartum cardiomyopathy--a new treatment option by inhibition of prolactin secretion. Am J Obstet Gynecol. 2008;199:e5–6.
Lampert MB, Lang RM. Peripartum cardiomyopathy. Am Heart J. 1995;130:860–70.
Mason JW, O’Connell JB, Herskowitz A, et al. A clinical trial of immunosuppressive therapy for myocarditis. The Myocarditis Treatment Trial Investigators. N Engl J Med. 1995;333:269–75.
Bozkurt B, Villaneuva FS, Holubkov R, et al. Intravenous immune globulin in the therapy of peripartum cardiomyopathy. J Am Coll Cardiol. 1999;34:177–80.
Fett JD, Christie LG, Carraway RD, Murphy JG. Five-year prospective study of the incidence and prognosis of peripartum cardiomyopathy at a single institution. Mayo Clin Proc. 2005;80:1602–6.
Mouquet F, Lions C, de Groote P, et al. Characterisation of peripartum cardiomyopathy by cardiac magnetic resonance imaging. Eur Radiol. 2008;18:2765–9.
Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018;138:e272–391.
Zimmerman H, Coelho-Anderson R, Smith R, Nolan P, Copeland J. Bridge to recovery with a thoratec biventricular assist device for postpartum cardiomyopathy. ASAIO J. 2010;56:479–80.
Emmert MY, Pretre R, Ruschitzka F, Krahenmann F, Falk V, Wilhelm MJ. Peripartum cardiomyopathy with cardiogenic shock: recovery after prolactin inhibition and mechanical support. Ann Thorac Surg. 2011;91:274–6.
Loyaga-Rendon RY, Pamboukian SV, Tallaj JA, et al. Outcomes of patients with peripartum cardiomyopathy who received mechanical circulatory support. Data from the Interagency Registry for Mechanically Assisted Circulatory Support. Circ Heart Fail. 2014;7:300–9.
Mathur NB, Dhingra D. Breastfeeding. Indian J Pediatr. 2014;81:143–9.
Safirstein JG, Ro AS, Grandhi S, Wang L, Fett JD, Staniloae C. Predictors of left ventricular recovery in a cohort of peripartum cardiomyopathy patients recruited via the internet. Int J Cardiol. 2012;154:27–31.
Elkayam U. Clinical characteristics of peripartum cardiomyopathy in the United States: diagnosis, prognosis, and management. J Am Coll Cardiol. 2011;58:659–70.
Curtis KM, Tepper NK, Jatlaoui TC, et al. U.S. medical eligibility criteria for contraceptive use, 2016. MMWR Recomm Rep. 2016;65:1–103.
Tepper NK, Paulen ME, Marchbanks PA, Curtis KM. Safety of contraceptive use among women with peripartum cardiomyopathy: a systematic review. Contraception. 2010;82:95–101.
Lo JO, Mission JF, Caughey AB. Hypertensive disease of pregnancy and maternal mortality. Curr Opin Obstet Gynecol. 2013;25:124–32.
James PR, Nelson-Piercy C. Management of hypertension before, during, and after pregnancy. Heart. 2004;90:1499–504.
Sibai BM, Caritis SN, Hauth JC, et al. Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies. The National institute of Child health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol. 2000;183:1520–4.
Ramakrishnan A, Lee LJ, Mitchell LE, Agopian AJ. Maternal hypertension during pregnancy and the risk of congenital heart defects in offspring: a systematic review and meta-analysis. Pediatr Cardiol. 2015;36:1442–51.
Hall ME, George EM, Granger JP. The heart during pregnancy. Rev Esp Cardiol. 2011;64:1045–50.
The American College of Obstetricians and Gynecologists. Preeclampsia and high blood pressure during pregnancy. https://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy. Accessed 20 June 2018.
The American College of Obstetricians and Gynecologists. Hypertension in pregnancy. https://www.acog.org/~/media/Task%20Force%20and%20Work%20Group%20Reports/public/HypertensioninPregnancy.pdf. Accessed 20 June 2018.
The SPRINT Research Group, A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2017;377:2506.
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127–248.
Sibai BM. Diagnosis and management of chronic hypertension in pregnancy. Obstet Gynecol. 1991;78:451–61.
Sibai BM. Treatment of hypertension in pregnant women. N Engl J Med. 1996;335:257–65.
Al-Maawali A, Walfisch A, Koren G. Taking angiotensin-converting enzyme inhibitors during pregnancy: is it safe? Can Fam Physician. 2012;58:49–51.
Buchbinder A, Sibai BM, Caritis S, et al. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol. 2002;186:66–71.
Hauth JC, Ewell MG, Levine RJ, et al. Pregnancy outcomes in healthy nulliparas who developed hypertension. Calcium for Preeclampsia Prevention Study Group. Obstet Gynecol. 2000;95:24–8.
Yoder SR, Thornburg LL, Bisognano JD. Hypertension in pregnancy and women of childbearing age. Am J Med. 2009;122:890–5.
Gaillard R, Steegers EA, Hofman A, Jaddoe VW. Associations of maternal obesity with blood pressure and the risks of gestational hypertensive disorders. The Generation R Study J Hypertens. 2011;29:937–44.
American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122:1122–31.
Hjartardottir S, Leifsson BG, Geirsson RT, Steinthorsdottir V. Recurrence of hypertensive disorder in second pregnancy. Am J Obstet Gynecol. 2006;194:916–20.
Brown MA, Mackenzie C, Dunsmuir W, et al. Can we predict recurrence of pre-eclampsia or gestational hypertension? BJOG. 2007;114:984–93.
Bellomo G, Venanzi S, Saronio P, Verdura C, Narducci PL. Prognostic significance of serum uric acid in women with gestational hypertension. Hypertension. 2011;58:704–8.
Melamed N, Ray JG, Hladunewich M, Cox B, Kingdom JC. Gestational hypertension and preeclampsia: are they the same disease? J Obstet Gynaecol Can. 2014;36:642–7.
Gyselaers W, Staelens A, Mesens T, et al. Maternal venous Doppler characteristics are abnormal in pre-eclampsia but not in gestational hypertension. Ultrasound Obstet Gynecol. 2015;45:421–6.
Beevers G, Lip GY, O’Brien E. ABC of hypertension: Blood pressure measurement. Part II—Conventional sphygmomanometry: technique of auscultatory blood pressure measurement. BMJ. 2001;322:1043–7.
Myers MG. A proposed algorithm for diagnosing hypertension using automated office blood pressure measurement. J Hypertens. 2010;28:703–8.
Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: Blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation. 2005;111:697–716.
Bakris GL. The implications of blood pressure measurement methods on treatment targets for blood pressure. Circulation. 2016;134:904–5.
Myers MG, Kaczorowski J, Dawes M, Godwin M. Automated office blood pressure measurement in primary care. Can Fam Physician. 2014;60:127–32.
ESH/ESC Task Force for the Management of Arterial Hypertension. 2013 Practice guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC): ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens. 2013;31:1925–38.
Tholl U, Forstner K, Anlauf M. Measuring blood pressure: pitfalls and recommendations. Nephrol Dial Transplant. 2004;19:766–70.
Leung AA, Nerenberg K, Daskalopoulou SS, et al. Hypertension Canada’s 2016 Canadian Hypertension Education Program Guidelines for blood pressure measurement, diagnosis, assessment of risk, prevention, and treatment of hypertension. Can J Cardiol. 2016;32:569–88.
Crowther CA, Bouwmeester AM, Ashurst HM. Does admission to hospital for bed rest prevent disease progression or improve fetal outcome in pregnancy complicated by non-proteinuric hypertension? Br J Obstet Gynaecol. 1992;99:13–7.
American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG Committee Opinion No. 421, November 2008: antibiotic prophylaxis for infective endocarditis. Obstet Gynecol. 2008;112:1193–4.
Sibai BM. Eclampsia. VI. Maternal-perinatal outcome in 254 consecutive cases. Am J Obstet Gynecol. 1990;163:1049–54. discussion 1054–5
Kilpatrick SJ, Abreo A, Greene N, et al. Severe maternal morbidity in a large cohort of women with acute severe intrapartum hypertension. Am J Obstet Gynecol. 2016;215:91.e91–7.
Coppage KH, Sibai BM. Treatment of hypertensive complications in pregnancy. Curr Pharm Des. 2005;11:749–57.
Magee LA, von Dadelszen P, Rey E, et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med. 2015;372:407–17.
Magee LA, von Dadelszen P, Singer J, et al. The CHIPS randomized controlled trial (control of hypertension in pregnancy study): is severe hypertension just an elevated blood pressure? Hypertension. 2016;68:1153–9.
Webster LM, Conti-Ramsden F, Seed PT, Webb AJ, Nelson-Piercy C, Chappell LC. Impact of antihypertensive treatment on maternal and perinatal outcomes in pregnancy complicated by chronic hypertension: a systematic review and meta-analysis. J Am Heart Assoc. 2017;6(5).
Pels A, Mol BWJ, Singer J, et al. Influence of gestational age at initiation of antihypertensive therapy: Secondary analysis of CHIPS trial data (Control of Hypertension in Pregnancy Study). Hypertension. 2018;71:1170–7.
Mancia G, De Backer G, Dominiczak A, et al. 2007 ESH-ESC practice guidelines for the management of arterial hypertension: ESH-ESC task force on the management of arterial hypertension. J Hypertens. 2007;25:1751–62.
Martin JN Jr, Thigpen BD, Moore RC, Rose CH, Cushman J, May W. Stroke and severe preeclampsia and eclampsia: a paradigm shift focusing on systolic blood pressure. Obstet Gynecol. 2005;105:246–54.
Brown CM, Garovic VD. Drug treatment of hypertension in pregnancy. Drugs. 2014;74:283–96.
Leddy MA, Power ML, Schulkin J. The impact of maternal obesity on maternal and fetal health. Rev Obstet Gynecol. 2008;1:170–8.
Abdul Sultan A, West J, Tata LJ, Fleming KM, Nelson-Piercy C, Grainge MJ. Risk of first venous thromboembolism in pregnant women in hospital: population based cohort study from England. BMJ. 2013;347:f6099.
Meher S, Abalos E, Carroli G. Bed rest with or without hospitalisation for hypertension during pregnancy. Cochrane Database Syst Rev. 2005:CD003514.
Hofmeyr GJ, Atallah AN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2006:CD001059.
Bushnell C, McCullough LD, Awad IA, et al. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45:1545–88.
Cockburn J, Moar VA, Ounsted M, Redman CW. Final report of study on hypertension during pregnancy: the effects of specific treatment on the growth and development of the children. Lancet. 1982;1:647–9.
Magee LA, Group CS, von Dadelszen P, et al. Do labetalol and methyldopa have different effects on pregnancy outcome? Analysis of data from the Control of Hypertension In Pregnancy Study (CHIPS) trial. BJOG. 2016;123:1143–51.
Ahn HK, Nava-Ocampo AA, Han JY, et al. Exposure to amlodipine in the first trimester of pregnancy and during breastfeeding. Hypertens Pregnancy. 2007;26:179–87.
Smith P, Anthony J, Johanson R. Nifedipine in pregnancy. BJOG. 2000;107:299–307.
Molvi SN, Mir S, Rana VS, Jabeen F, Malik AR. Role of antihypertensive therapy in mild to moderate pregnancy-induced hypertension: a prospective randomized study comparing labetalol with alpha methyldopa. Arch Gynecol Obstet. 2012;285:1553–62.
WFt P, Hilleman DE, Levy PD, Rhoney DH, Varon J. A systematic review of nicardipine vs labetalol for the management of hypertensive crises. Am J Emerg Med. 2012;30:981–93.
Webster LM, Myers JE, Nelson-Piercy C, et al. Labetalol versus nifedipine as antihypertensive treatment for chronic hypertension in pregnancy: a randomized controlled trial. Hypertension. 2017;70:915–22.
Peacock WF, Varon J, Baumann BM, et al. CLUE: a randomized comparative effectiveness trial of IV nicardipine versus labetalol use in the emergency department. Crit Care. 2011;15:R157.
Committee on Obstetric Practice. Committee opinion no. 692: Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2017;129:e90–5.
Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2016;67:e27–e115.
Li JM, Nguyen C, Joglar JA, Hamdan MH, Page RL. Frequency and outcome of arrhythmias complicating admission during pregnancy: experience from a high-volume and ethnically-diverse obstetric service. Clin Cardiol. 2008;31:538–41.
Shotan A, Ostrzega E, Mehra A, Johnson JV, Elkayam U. Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness, and syncope. Am J Cardiol. 1997;79:1061–4.
Franz MR, Cima R, Wang D, Profitt D, Kurz R. Electrophysiological effects of myocardial stretch and mechanical determinants of stretch-activated arrhythmias. Circulation. 1992;86:968–78.
Roberts JM, Insel PA, Goldfien A. Regulation of myometrial adrenoreceptors and adrenergic response by sex steroids. Mol Pharmacol. 1981;20:52–8.
Soliman EZ, Elsalam MA, Li Y. The relationship between high resting heart rate and ventricular arrhythmogenesis in patients referred to ambulatory 24 h electrocardiographic recording. Europace. 2010;12:261–5.
Joglar JA, Page RL. Management of arrhythmia syndromes during pregnancy. Curr Opin Cardiol. 2014;29:36–44.
Li Y, Rabey KN, Schmitt D, Norton JN, Reynolds RP. Characteristics of vibration that alter cardiovascular parameters in mice. J Am Assoc Lab Anim Sci. 2015;54:372–7.
Lee SH, Chen SA, Wu TJ, et al. Effects of pregnancy on first onset and symptoms of paroxysmal supraventricular tachycardia. Am J Cardiol. 1995;76:675–8.
Silversides CK, Harris L, Haberer K, Sermer M, Colman JM, Siu SC. Recurrence rates of arrhythmias during pregnancy in women with previous tachyarrhythmia and impact on fetal and neonatal outcomes. Am J Cardiol. 2006;97:1206–12.
Ghosh N, Luk A, Derzko C, Dorian P, Chow CM. The acute treatment of maternal supraventricular tachycardias during pregnancy: a review of the literature. J Obstet Gynaecol Can. 2011;33:17–23.
Allen NM, Page RL. Procainamide administration during pregnancy. Clin Pharm. 1993;12:58–60.
Qasqas SA, McPherson C, Frishman WH, Elkayam U. Cardiovascular pharmacotherapeutic considerations during pregnancy and lactation. Cardiol Rev. 2004;12:201–21.
Doig JC, McComb JM, Reid DS. Incessant atrial tachycardia accelerated by pregnancy. Br Heart J. 1992;67:266–8.
DiCarlo-Meacham A, Dahlke J. Atrial fibrillation in pregnancy. Obstet Gynecol. 2011;117:489–92.
Rathore SS, Wang Y, Krumholz HM. Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med. 2002;347:1403–11.
Goland S, Elkayam U. Anticoagulation in pregnancy. Cardiol Clin. 2012;30:395–405.
Brodsky M, Doria R, Allen B, Sato D, Thomas G, Sada M. New-onset ventricular tachycardia during pregnancy. Am Heart J. 1992;123:933–41.
Lemery R, Brugada P, Bella PD, Dugernier T, van den Dool A, Wellens HJ. Nonischemic ventricular tachycardia. Clinical course and long-term follow-up in patients without clinically overt heart disease. Circulation. 1989;79:990–9.
Cleary-Goldman J, Salva CR, Infeld JI, Robinson JN. Verapamil-sensitive idiopathic left ventricular tachycardia in pregnancy. J Matern Fetal Neonatal Med. 2003;14:132–5.
Page RL, Hamdan MH, Joglar JA. Arrhythmias occurring during pregnancy. Card Electrophysiol Rev. 2002;6:136–9.
Shenker L. Fetal cardiac arrhythmias. Obstet Gynecol Surv. 1979;34:561–72.
Strasburger JF, Wakai RT. Fetal cardiac arrhythmia detection and in utero therapy. Nat Rev Cardiol. 2010;7:277–90.
Copel JA, Liang RI, Demasio K, Ozeren S, Kleinman CS. The clinical significance of the irregular fetal heart rhythm. Am J Obstet Gynecol. 2000;182:813–7; discussion 817–9
Cuneo BF, Strasburger JF, Wakai RT, Ovadia M. Conduction system disease in fetuses evaluated for irregular cardiac rhythm. Fetal Diagn Ther. 2006;21:307–13.
Boldt T, Eronen M, Andersson S. Long-term outcome in fetuses with cardiac arrhythmias. Obstet Gynecol. 2003;102:1372–9.
Donofrio MT, Moon-Grady AJ, Hornberger LK, et al. Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American Heart Association. Circulation. 2014;129:2183–242.
van Engelen AD, Weijtens O, Brenner JI, et al. Management outcome and follow-up of fetal tachycardia. J Am Coll Cardiol. 1994;24:1371–5.
Hahurij ND, Gittenberger-De Groot AC, Kolditz DP, et al. Accessory atrioventricular myocardial connections in the developing human heart: relevance for perinatal supraventricular tachycardias. Circulation. 2008;117:2850–8.
Wakai RT, Strasburger JF, Li Z, Deal BJ, Gotteiner NL. Magnetocardiographic rhythm patterns at initiation and termination of fetal supraventricular tachycardia. Circulation. 2003;107:307–12.
Alsaied T, Baskar S, Fares M, et al. First-line antiarrhythmic transplacental treatment for fetal tachyarrhythmia: a systematic review and meta-analysis. J Am Heart Assoc 2017;6.
Hill GD, Kovach JR, Saudek DE, Singh AK, Wehrheim K, Frommelt MA. Transplacental treatment of fetal tachycardia: a systematic review and meta-analysis. Prenat Diagn. 2017;37:1076–83.
Naheed ZJ, Strasburger JF, Deal BJ, Benson DW Jr, Gidding SS. Fetal tachycardia: mechanisms and predictors of hydrops fetalis. J Am Coll Cardiol. 1996;27:1736–40.
Oudijk MA, Ruskamp JM, Ververs FF, et al. Treatment of fetal tachycardia with sotalol: transplacental pharmacokinetics and pharmacodynamics. J Am Coll Cardiol. 2003;42:765–70.
Shah A, Moon-Grady A, Bhogal N, et al. Effectiveness of sotalol as first-line therapy for fetal supraventricular tachyarrhythmias. Am J Cardiol. 2012;109:1614–8.
Ebenroth ES, Cordes TM, Darragh RK. Second-line treatment of fetal supraventricular tachycardia using flecainide acetate. Pediatr Cardiol. 2001;22:483–7.
Castillo RA, Devoe LD, Hadi HA, Martin S, Geist D. Nonimmune hydrops fetalis: clinical experience and factors related to a poor outcome. Am J Obstet Gynecol. 1986;155:812–6.
Wy CA, Sajous CH, Loberiza F, Weiss MG. Outcome of infants with a diagnosis of hydrops fetalis in the 1990s. Am J Perinatol. 1999;16:561–7.
Parilla BV, Strasburger JF, Socol ML. Fetal supraventricular tachycardia complicated by hydrops fetalis: a role for direct fetal intramuscular therapy. Am J Perinatol. 1996;13:483–6.
The American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 106: Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles. Obstet Gynecol. 2009;114:192–202.
Schmidt KG, Ulmer HE, Silverman NH, Kleinman CS, Copel JA. Perinatal outcome of fetal complete atrioventricular block: a multicenter experience. J Am Coll Cardiol. 1991;17:1360–6.
Buyon JP, Winchester R. Congenital complete heart block. A human model of passively acquired autoimmune injury. Arthritis Rheum. 1990;33:609–14.
Buyon JP, Clancy RM, Friedman DM. Autoimmune associated congenital heart block: integration of clinical and research clues in the management of the maternal/foetal dyad at risk. J Intern Med. 2009;265:653–62.
Buyon JP, Hiebert R, Copel J, et al. Autoimmune-associated congenital heart block: demographics, mortality, morbidity and recurrence rates obtained from a national neonatal lupus registry. J Am Coll Cardiol. 1998;31:1658–66.
Ozkutlu S, Onderoglu L, Karagoz T, Celiker A, Sahiner UM. Isolated noncompaction of left ventricular myocardium with fetal sustained bradycardia due to sick sinus syndrome. Turk J Pediatr. 2006;48:383–6.
Glatz AC, Gaynor JW, Rhodes LA, et al. Outcome of high-risk neonates with congenital complete heart block paced in the first 24 hours after birth. J Thorac Cardiovasc Surg. 2008;136:767–73.
Berg C, Geipel A, Kohl T, et al. Atrioventricular block detected in fetal life: associated anomalies and potential prognostic markers. Ultrasound Obstet Gynecol. 2005;26:4–15.
Zhao H, Cuneo BF, Strasburger JF, Huhta JC, Gotteiner NL, Wakai RT. Electrophysiological characteristics of fetal atrioventricular block. J Am Coll Cardiol. 2008;51:77–84.
Hofbeck M, Ulmer H, Beinder E, Sieber E, Singer H. Prenatal findings in patients with prolonged QT interval in the neonatal period. Heart. 1997;77:198–204.
Mitchell JL, Cuneo BF, Etheridge SP, Horigome H, Weng HY, Benson DW. Fetal heart rate predictors of long QT syndrome. Circulation. 2012;126:2688–95.
Joglar JA, Page RL. Treatment of cardiac arrhythmias during pregnancy: safety considerations. Drug Saf. 1999;20:85–94.
Pittard WB 3rd, Glazier H. Procainamide excretion in human milk. J Pediatr. 1983;102:631–3.
Barnett DB, Hudson SA, McBurney A. Disopyramide and its N-monodesalkyl metabolite in breast milk. Br J Clin Pharmacol. 1982;14:310–2.
MacKintosh D, Buchanan N. Excretion of disopyramide in human breast milk. Br J Clin Pharmacol. 1985;19:856–7.
Ortega D, Viviand X, Lorec AM, Gamerre M, Martin C, Bruguerolle B. Excretion of lidocaine and bupivacaine in breast milk following epidural anesthesia for cesarean delivery. Acta Anaesthesiol Scand. 1999;43:394–7.
Zeisler JA, Gaarder TD, De Mesquita SA. Lidocaine excretion in breast milk. Drug Intell Clin Pharm. 1986;20:691–3.
Lewis AM, Patel L, Johnston A, Turner P. Mexiletine in human blood and breast milk. Postgrad Med J. 1981;57:546–7.
Echt DS, Liebson PR, Mitchell LB, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med. 1991;324:781–8.
Kulas J, Lunell NO, Rosing U, Steen B, Rane A. Atenolol and metoprolol. A comparison of their excretion into human breast milk. Acta Obstet Gynecol Scand Suppl. 1984;118:65–9.
Libardoni M, Piovan D, Busato E, Padrini R. Transfer of propafenone and 5-OH-propafenone to foetal plasma and maternal milk. Br J Clin Pharmacol. 1991;32:527–8.
Bartalena L, Bogazzi F, Braverman LE, Martino E. Effects of amiodarone administration during pregnancy on neonatal thyroid function and subsequent neurodevelopment. J Endocrinol Invest. 2001;24:116–30.
Plomp TA, Vulsma T, de Vijlder JJ. Use of amiodarone during pregnancy. Eur J Obstet Gynecol Reprod Biol. 1992;43:201–7.
Kozlowski D, Budrejko S, Lip GY, et al. Dronedarone: an overview. Ann Med. 2012;44:60–72.
Byerly WG, Hartmann A, Foster DE, Tannenbaum AK. Verapamil in the treatment of maternal paroxysmal supraventricular tachycardia. Ann Emerg Med. 1991;20:552–4.
Anderson P, Bondesson U, Mattiasson I, Johansson BW. Verapamil and norverapamil in plasma and breast milk during breast feeding. Eur J Clin Pharmacol. 1987;31:625–7.
Elkayam U, Goodwin TM. Adenosine therapy for supraventricular tachycardia during pregnancy. Am J Cardiol. 1995;75:521–3.
Page RL. Treatment of arrhythmias during pregnancy. Am Heart J. 1995;130:871–6.
Schroeder JS, Harrison DC. Repeated cardioversion during pregnancy. Treatment of refractory paroxysmal atrial tachycardia during 3 successive pregnancies. Am J Cardiol. 1971;27:445–6.
McCollough CH, Schueler BA, Atwell TD, et al. Radiation exposure and pregnancy: when should we be concerned? Radiographics. 2007;27:909–17; discussion 917–8
Damilakis J, Theocharopoulos N, Perisinakis K, et al. Conceptus radiation dose and risk from cardiac catheter ablation procedures. Circulation. 2001;104:893–7.
Szumowski L, Szufladowicz E, Orczykowski M, et al. Ablation of severe drug-resistant tachyarrhythmia during pregnancy. J Cardiovasc Electrophysiol. 2010;21:877–82.
Natale A, Davidson T, Geiger MJ, Newby K. Implantable cardioverter-defibrillators and pregnancy: a safe combination? Circulation. 1997;96:2808–12.
Jordaens LJ, Vandenbogaerde JF, Van de Bruaene P, De Buyzere M. Transesophageal echocardiography for insertion of a physiological pacemaker in early pregnancy. Pacing Clin Electrophysiol. 1990;13:955–7.
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Coulter, S.A., Lew, J., Jenny, B. (2020). Heart Disease in Pregnancy. In: Carabello, B. (eds) Valvular Heart Disease. Cardiovascular Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-2840-3_12
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