Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC)
Jolien W. Roos-Hesselink,Jolien W. Roos-Hesselink,Lucia Baris,Mark R. Johnson,Julie De Backer,Catherine M Otto,Ariane Marelli,Guillaume Jondeau,Werner Budts,Jasmine Grewal,Karen Sliwa,William A. Parsonage,Aldo P. Maggioni,Iris M. van Hagen,Alec Vahanian,Luigi Tavazzi,Uri Elkayam,Eric Boersma,Roger Hall +18 more
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TLDR
Rates of maternal mortality or heart failure were high in women with heart disease from 2007 to 2010, however, from 2010, these rates declined despite the inclusion of more high-risk pregnancies.Abstract:
Aims Reducing maternal mortality is a World Health Organization (WHO) global health goal. Although maternal deaths due to haemorrhage and infection are declining, those related to heart disease are increasing and are now the most important cause in western countries. The aim is to define contemporary diagnosis-specific outcomes in pregnant women with heart disease. Methods and results From 2007 to 2018, pregnant women with heart disease were prospectively enrolled in the Registry Of Pregnancy And Cardiac disease (ROPAC). Primary outcome was maternal mortality or heart failure, secondary outcomes were other cardiac, obstetric, and foetal complications. We enrolled 5739 pregnancies; the mean age was 29.5. Prevalent diagnoses were congenital (57%) and valvular heart disease (29%). Mortality (overall 0.6%) was highest in the pulmonary arterial hypertension (PAH) group (9%). Heart failure occurred in 11%, arrhythmias in 2%. Delivery was by Caesarean section in 44%. Obstetric and foetal complications occurred in 17% and 21%, respectively. The number of high-risk pregnancies (mWHO Class IV) increased from 0.7% in 2007–2010 to 10.9% in 2015–2018. Determinants for maternal complications were pre-pregnancy heart failure or New York Heart Association >II, systemic ejection fraction <40%, mWHO Class 4, and anticoagulants use. After an increase from 2007 to 2009, complication rates fell from 13.2% in 2010 to 9.3% in 2017. Conclusion Rates of maternal mortality or heart failure were high in women with heart disease. However, from 2010, these rates declined despite the inclusion of more high-risk pregnancies. Highest complication rates occurred in women with PAH.read more
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2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
Catherine M Otto,Rick A. Nishimura,Robert O. Bonow,Blase A. Carabello,John P. Erwin,Federico Gentile,Hani Jneid,Eric V. Krieger,Michael Mack,Christopher J. McLeod,Patrick T. O'Gara,Vera H. Rigolin,Thoralf M. Sundt,Annemarie Thompson,Christopher Toly +14 more
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2020 ESC Guidelines for the management of adult congenital heart disease.
Helmut Baumgartner,Julie De Backer,Sonya V. Babu-Narayan,Werner Budts,Massimo Chessa,Gerhard-Paul Diller,Bernard Lung,Jolanda Kluin,Irene M. Lang,Folkert J. Meijboom,Philip Moons,Barbara J.M. Mulder,Erwin Oechslin,Jolien W. Roos-Hesselink,Markus Schwerzmann,Lars Søndergaard,Katja Zeppenfeld,Sabine Ernst,Magalie Ladouceur,Victor Aboyans,David Alexander,Ruxandra Christodorescu,Domenico Corrado,Michele D'Alto,Natasja M.S. de Groot,Victoria Delgado,Giovanni Di Salvo,Laura Dos Subira,Andreas Eicken,Donna Fitzsimons,Alexandra Frogoudaki,Michael A. Gatzoulis,Stephane Heymans,Jürgen Hörer,Lucile Houyel,Guillaume Jondeau,Hugo A. Katus,Ulf Landmesser,Basil S. Lewis,Alexander R. Lyon,Christian Mueller,Darren Mylotte,Steffen E. Petersen,Anna Sonia Petronio,Marco Roffi,Raphael Rosenhek,Evgeny Shlyakhto,Iain A. Simpson,Miguel Sousa-Uva,Christian Torp-Pedersen,Rhian M. Touyz,Alexander Van De Bruaene,Bernard Iung +52 more
TL;DR: Praha f Interní kardiologická klinika, Fakultní nemocnice Brno a Centrum komplexní péče o vrozené srdeční vady v dospělosti, Brno
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2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
Catherine M Otto,Rick A. Nishimura,Robert O. Bonow,Blase A. Carabello,John P. Erwin,Federico Gentile,Hani Jneid,Eric V. Krieger,Michael Mack,Christopher J. McLeod,Patrick T. O'Gara,Vera H. Rigolin,Thoralf M. Sundt,Annemarie Thompson,Christopher Toly +14 more
TL;DR: The reader is referred to the full guideline for graphical flow charts, text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in developing these guidelines.
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2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease
Catherine M Otto,Rick A. Nishimura,Robert O. Bonow,Blase A. Carabello,John P. Erwin,Federico Gentile,Hani Jneid,Eric V. Krieger,Michael Mack,Christopher J. McLeod,Patrick T. O'Gara,Vera H. Rigolin,Thoralf M. Sundt,Annemarie Thompson,Christopher Toly +14 more
References
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WHO analysis of causes of maternal death: a systematic review
TL;DR: Haemorrhage and hypertensive disorders are major contributors to maternal deaths in developing countries and these data should inform evidence-based reproductive health-care policies and programmes at regional and national levels.
Journal ArticleDOI
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).
Vera Regitz-Zagrosek,Carina Blomström Lundqvist,Claudio Borghi,Renata Cifkova,Rafael Ferreira,Jean-Michel Foidart,J Simon R Gibbs,Christa Gohlke-Baerwolf,Bulent Gorenek,Bernard Iung,Mike Kirby,Angela H E M Maas,João Morais,Petros Nihoyannopoulos,Petronella G. Pieper,Patrizia Presbitero,Jolien W. Roos-Hesselink,Maria Schaufelberger,Ute Seeland,Lucia Torracca,Jeroen J. Bax,A Auricchio,Helmut Baumgartner,Claudio Ceconi,Veronica Dean,Christi Deaton,Robert Fagard,Christian Funck-Brentano,David Hasdai,Arno W. Hoes,Juhani Knuuti,Philippe Kolh,Theresa McDonagh,Cyril Moulin,Don Poldermans,Bogdan Alexandru Popescu,Zeljko Reiner,Udo Sechtem,Per Anton Sirnes,Adam Torbicki,Alec Vahanian,Stephan Windecker,Carlos Aguiar,Nawwar Al-Attar,Angeles Alonso Garcia,Anna Antoniou,I M Coman,Uri Elkayam,Miguel Ángel Gómez-Sánchez,Nina Gotcheva,Denise Hilfiker-Kleiner,Róbert Gábor Kiss,Anastasia Kitsiou,Karen T S Konings,Gregory Y.H. Lip,Athanasios J. Manolis,Alexandre Mebaaza,Iveta Mintale,Marie Claude Morice,Barbara J.M. Mulder,Agnes Pasquet,Susanna Price,Silvia G. Priori,Maria J Salvador,Avraham Shotan,Candice K. Silversides,Sven O Skouby,Jörg Ingolf Stein,Pilar Tornos,Niels Vejlstrup,Fiona Walker,Carole A. Warnes +71 more
TL;DR: Recommendations for the prevention and management of venous thrombo-embolism in pregnancy and puerperium and the associated risk groups according to risk factors: definition and preventive measures are presented.
ESC Guidelines on the management of cardiovascular diseases during pregnancy The Task Force on the Management of Cardiovascular Diseases
Carina Blomström Lundqvist,Rafael Ferreira,Jean-Michel Foidart,Joshua D. Simon,R. Gibbs,Angela H.E.M. Maas,Petronella G. Pieper,Jolien W. Roos-Hesselink,Maria Schaufelberger +8 more
TL;DR: In this paper, the authors presented a list of risk factors for venous thrombo-embolism in pregnancy and puerperium in women with heart disease, including the following risk factors: hypertension, congestive heart failure, hypertension, age (>75 years), diabetes, stroke, and atrial septal defect.
Journal ArticleDOI
Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group
Leontine Alkema,Doris Chou,Daniel R Hogan,Sanqian Zhang,Ann Beth Moller,Alison Gemmill,Doris Ma Fat,Ties Boerma,Marleen Temmerman,Colin Mathers,Lale Say +10 more
TL;DR: Based on MMR estimates for 2015, scenario-based projections are constructed to highlight the accelerations needed to accomplish the Sustainable Development Goal (SDG) global target of less than 70 maternal deaths per 100,000 live births globally by 2030.
Journal ArticleDOI
2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy
Vera Regitz-Zagrosek,Jolien W. Roos-Hesselink,Johann Bauersachs,Carina Blomstrom-Lundqvist,Renata Cifkova,Michele De Bonis,Bernard Iung,Mark R. Johnson,Ulrich Kintscher,Peter Kranke,Irene Marthe Lang,João Morais,Petronella G. Pieper,Patrizia Presbitero,Susanna Price,Giuseppe M.C. Rosano,Ute Seeland,Tommaso Simoncini,Lorna Swan,Carole A Warnes +19 more
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