Obstetric anaesthesia and peripartum management
Anaesthetists play a key role in the management of parturients with cardiac disease. Pregnant women with cardiac disease should be seen antenatally in a high-risk obstetric anaesthesia clinic, and a…
Pregnancy and pulmonary hypertension
Pulmonary hypertension during pregnancy is associated with considerable risks of maternal mortality and morbidity. Our systematic review of the literature on the use of targeted treatments for pulmonary arterial hypertension…
Pregnancy in inherited and acquired cardiomyopathies
Cardiomyopathy encompasses a wide spectrum of heart muscle disease, which can have an impact on the patient’s ability to sustain the increased cardiac workload of pregnancy. Pregnancy can also unmask…
Heart disease in pregnancy: Ischaemic heart disease
Coronary artery disease and in particular acute coronary syndromes in pregnancy are increasing with high risk of mortality and significant morbidity. Whilst women with atherosclerotic risk factors are at greater…
Aorta pathology and pregnancy
In addition to the haemodynamic changes in pregnancy, hormones also induce changes in the aortic wall. Women with diseases like Marfan syndrome, Ehlers–Danlo syndrome, or other aortic abnormalities, have an…
Thromboembolism in pregnancy: Challenges and controversies in the prevention of pregnancy-associated venous thromboembolism and management of anticoagulation in women with mechanical prosthetic heart valves
Thromboembolism in pregnancy is an important clinical issue. Despite identification of maternal and pregnancy-specific risk factors for development of pregnancy-associated venous thromboembolism, limited data are available to inform on optimal…
Valvular heart disease in pregnancy
In women with valvular heart disease, pregnancy-associated cardiovascular changes can contribute to maternal, foetal and neonatal complications. Ideally, a woman with valvular heart disease should receive preconception assessment and counselling…
Congenital heart disease in pregnancy
The story of congenital heart disease is one of the major successes of medicine in the last 50 years. Heart conditions previously associated with early death are now successfully treated….
Risk stratification and hierarchy of antenatal care
Cardiac disease is the leading cause of maternal death in the UK. The triennial maternal mortality reports have repeatedly highlighted failure to recognise the level of risk as a major…
Drugs and therapeutics, including contraception, for women with heart disease
Cardiac disease remains the leading cause of maternal death in the UK, and data from the Centre for Maternal and Child Enquiries have shown that the numbers of women dying…
