Medical and Surgical Complications during Pregnancy I Heart Deseases in Pregnancy
Medical and Surgical Complications during Pregnancy Heart Deseases in Pregnancy
Incidence Heart disease complicates about 1 percent of pregnancies. Component congenital heart disease hematic heart disease hypertensive heart disease other varieties (inclued: pregnancy-induced hypertension, thyroid, coronary, syphilitic, and kyphoscoliotic cardiac disease) idiopathic cardiomyopathy(perinatal cardiomyopathy) isolated myocarditis various forms of heart block
Incidence • Heart disease complicates about 1 percent of pregnancies. Component • congenital heart disease • rheumatic heart disease • hypertensive heart disease • other varieties (inclued: pregnancy-induced hypertension, thyroid, coronary, syphilitic, and kyphoscoliotic cardiac disease) • idiopathic cardiomyopathy (perinatal cardiomyopathy) • isolated myocarditis • various forms of heart block
Maternal mortality 0.3 per 10,000 live births Heart disease still significantly contributes to maternal mortality. 5.6-8.5 percent of maternal deaths
• 0.3 per 10,000 live births Heart disease still significantly contributes to maternal mortality. • 5.6-8.5 percent of maternal deaths Maternal mortality
Effect of pregnancy on heart disease The pregnant period Cardiac output is increased by as much as 30-50 percent almost half of the total increase has occurred by 8 weeks, and it is maximized by mid pregnancy. Total blood volume is increased about 35% from 6th week to 32nd week Stroke volume is increased by 20-4090 Resting pulse is increased(by 10-17%0) The changes of anatomic positions heart, diaphragm, uterus. formation of utero-placental circulation
Effect of pregnancy on heart disease ➢The pregnant period • Cardiac output is increased by as much as 30-50 percent ✓ almost half of the total increase has occurred by 8 weeks, and it is maximized by mid pregnancy. • Total blood volume is increased about 35%. ✓ from 6th week to 32nd week • Stroke volume is increased by 20-40%. • Resting pulse is increased (by 10-17%) • The changes of anatomic positions ✓ heart, diaphragm, uterus. formation of utero-placental circulation
Labor and delivery. Consumption of energy and oxygen is further increased Labor is increased maternal cardiac burdens Expulsion of the fetus and placenta produce a dematic hemodynamic changes The puerperium After delivery of the fetus and placenta, during 1-2 days. great amont of blood return into the systemic circulation, and great amont of fluid from intertissue space return to the systemic circulation, increase cardiac burdens again. 32-34 gestational weeks, during the labor and delivery, and early postpartum period(1-3 days)are the most danger time for pregnant women with heart disease. It is easy development heart failure
➢ Labor and delivery • Consumption of energy and oxygen is further increased. • Labor is increased maternal cardiac burdens. • Expulsion of the fetus and placenta produce a drematic hemodynamic changes . ➢ The puerperium • After delivery of the fetus and placenta, during 1-2 days, great amont of blood return into the systemic circulation, and great amont of fluid from intertissue space return to the systemic circulation, increase cardiac burdens again. • 32-34 gestational weeks, during the labor and delivery, and early postpartum period (1-3 days) are the most danger time for pregnant women with heart disease. It is easy development heart failure