Maternal disorders

Question 1

Pregnancy is contraindicated in which maternal cardiac conditions ?

Answer 1

Modified WHO maternal cardiovasc risk

• Pulmonary arterial hypertension
• Severe systemic ventricular dysfunction (EF <30% or NYHA Class III-IV)
• Previous peripartum cardiomyopathy with any residual left ventricular impairment
• Severe mitral stenosis
• Severe symptomatic aortic stenosis
• Systemic right ventricle with moderate or severely decreased ventricular function
• Severe aortic dilatation (>45mm in Marfan syndrome or other HTAD, >50mm in bicuspid aortic valve, Turner syndrome ASI>25mm/m2, TOF >50mm)
• Vascular Ehlers-Danlos
• Severe (re)coarctation
• Fontan with complication

Question 2

Contraindications to rescue cerclage

Answer 2

• Fetal anomaly incompatible with life
• Intrauterine infection
• Active bleeding
• Active preterm labor
• Preterm Premature rupture of membranes (PPROM)
• Fetal demise