Heart Diseases Flashcards
Types of Heart Disease in Pregnancy
Classifications of Heart Disease in Pregnancy
- NEW YORK HEART ASSOCIATION (NYHA) CLASSIFICATION: CLINICAL CLASSIFICATION.
- ACOG CLASSIFICATION: ACCORDING TO RISK OF MATERNAL MORTALITY.
Classifications of Heart Disease in Pregnancy
- NHYA
Classifications of Heart Disease in Pregnancy
- NHYA (Class I)
- Asymptomatic (uncompromised) .
Classifications of Heart Disease in Pregnancy
- NHYA (Class II)
- Symptomatic with heavy exertion (slightly compromised)
Classifications of Heart Disease in Pregnancy
- NHYA (Class III)
- Symptomatic with light exertion (markedly com promised)
Classifications of Heart Disease in Pregnancy
- NHYA (Class IV)
- Symptomatic at rest (severely compromised).
Classifications of Heart Disease in Pregnancy
- ACOG
Classifications of Heart Disease in Pregnancy
- ACOG (Group I)
Classifications of Heart Disease in Pregnancy
- ACOG (Group II)
Classifications of Heart Disease in Pregnancy
- ACOG (Group III)
Effects of Pregnancy on Heart Disease
Effects of Pregnancy on Heart Disease
- HF
Effects of Pregnancy on Heart Disease
- Acute PE
Due to acute LSHF
Effects of Pregnancy on Heart Disease
- Infective Endocarditis
More è puerperal sepsis.
Effects of Heart Disease on Pregnancy
Maternal & Fetal
Effects of Heart Disease on Pregnancy
- Maternal
Effects of Heart Disease on Pregnancy
- Fetal
Dx of Heart Disease on Pregnancy
Dx of Heart Disease on Pregnancy
- Most Reliable Investigation
Echocardiography:
Managment of Heart Disease on Pregnancy
- Preconceptional care
- During Pregnancy
- During Delivery
- Neonatal Care
- Post Natal Care
Managment of Heart Disease on Pregnancy
- Preconceptional Care
Managment of Heart Disease on Pregnancy
- During Pregnancy
- ANC
- Medical Care
- Observation
- Corrective Cardiac Suregry
- TOP
TTT of Complications
ANC for Heart Disease on Pregnancy
Frequency of Visits in Heart Disease on Pregnancy
- When to hospitalize Class I & II?
- () 28-32 weeks.
- At 36 weeks.
- At any time when complications occur.
Medical Care in Heart Disease on Pregnancy
- Antibiotics
- Prevention of HF
- Prevention of acute pulmonary edema
Observation of Heart Disease on Pregnancy
Corrective Cardiac Surgery for Heart Disease on Pregnancy
Corrective Cardiac Surgery for Heart Disease on Pregnancy
- Indications
- chronically ill patients not responding to medical treatment.
- Although it is better to be done after pregnancy
Corrective Cardiac Surgery for Heart Disease on Pregnancy
- Time
When indicated, it is better to be done during 2nd trimester
(general rule of surgery during pregnancy).
Corrective Cardiac Surgery for Heart Disease on Pregnancy
- Types
- Closed cardiac surgery (valvotomy): → Safer during pregnancy.
- Opened cardiac surgery (valve replacement): → Not preferred
during pregnancy.
Indications of TOP in Heart Disease on Pregnancy (Induction of Therapeutic Abortion)
Time of TOP in Heart Disease on Pregnancy (Induction of Therapeutic Abortion)
- Done before 12 weeks (after 12 weeks, risk of TOP is > risk of continuation).
Method of TOP in Heart Disease on Pregnancy (Induction of Therapeutic Abortion)
Suction evacuation under heavy sedation & prophylactic antibiotics.
TTT of Complications in Heart Disease on Pregnancy (Induction of Therapeutic Abortion)
Managment of Heart Disease on Pregnancy
- Managment of Delivery
Managment of Heart Disease on Pregnancy during Delivery
- Time of Delivery
Usually pregnancy is allowed to continue till term & elective preterm delivery is rarely indicated in cardiac cases.
Managment of Heart Disease on Pregnancy during Delivery
- Methods of Delivery
Vaginal & CS
Managment of Heart Disease on Pregnancy during Delivery
- Indications of Vaginal Delivery
The rule unless CS is indicated.
Precautions of vaginal Delivery in Managment of Heart Disease on Pregnancy
- During 1st Stage
Precautions of vaginal Delivery in Managment of Heart Disease on Pregnancy
- During 2nd Stage
- Avoid bearing down.
- Shortening of 2nd stage by ventouse (better) or low forceps.
Precautions of vaginal Delivery in Managment of Heart Disease on Pregnancy
- During 3rd Stage
Indications of CS Delivery in cases of Heart Disease in Pregnancy
Managment of Surgically Corrected Heaty in pregnancy
- Cardiac Valve Replacment