New guidelines have been drawn up to tackle “major concerns” about complications in heart disease among pregnant women.
Published by the European Society of Cardiology, and launched at the 2011 ESC Congress in Paris, France, the guidelines on the management of heart disease in pregnancy are published in the European Heart Journal.
Although pre-existing heart disease is rarely a contraindication to pregnancy, experts are concerned by the fact that complications are frequent and in some cases may be life-threatening for both mother and baby.
In Europe maternal heart disease has now become the major cause of maternal death during pregnancy.
The risk of heart disease in pregnancy is continuing to rise in developed countries, mainly because many women are older when they have their first pregnancy, which comes with associated increase in risks of diabetes, hypertension and obesity.
The improvement in the treatment of congenital heart disease has also led to a greater number of women with heart disease reaching childbearing age.
The guidelines, which are separated into eight specific disease groups, describe careful screening for heart disease, appropriate risk assessment and counselling as "crucial".
Although much can be carried out in primary care, if heart disease is suspected or confirmed, its management is best undertaken by interdisciplinary teams and high risk patients should be treated in specialised centres.
A separate section on heart drugs during pregnancy recommends follow-up during pregnancy, medical therapy and intervention where appropriate, as well as delivery and postpartum care.
"We are convinced that this guideline document is an important contribution and will be considered very helpful for the management of cardiovascular disease during pregnancy in clinical practice,” say the authors.
ESC Guidelines on the management of cardiovascular disease during pregnancy. Eur Heart J 2011; doi:10.1093/eurheartj/ehr218.
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