Assessing Cardiac Risk in Pregnant Women With Heart Disease : How Risk Scores Are Created and Their Role in Clinical Practice

Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved..

Pregnancy, which is associated with profound cardiovascular changes and higher risk of thrombosis, increases the risk of cardiovascular complications in women with pre-existing heart disease. A comprehensive history and physical examination, 12-lead electrocardiogram, and transthoracic echocardiogram remain the foundation of assessing cardiac risk during pregnancy in women with heart disease. These are often combined to generate risk scores, which are statistically derived. Several statistically derived risk and 1 lesion-specific classification system are currently available. A suggested clinical approach to risk stratification is first to identify pregnancies in women with cardiac lesions at risk for serious or life-threatening maternal cardiac complications and for the remainder to use the Cardiac Disease in Pregnancy II (CARPREG II) risk score, integrating additional lesion-specific and patient-specific information. Conversely, clinicians can use the modified World Health Organization (mWHO) risk classification system and integrate general risk predictors and patient-specific information. Importantly, cardiac-risk assessment should always incorporate clinical judgement in addition to the use of risk scores or risk-classification systems. As pregnant women with heart disease are also at risk for obstetric and fetoneonatal complications, risk assessment should be performed by a multidisciplinary team, preferably before conception, or as soon as conception is confirmed, and repeated at regular intervals during the course of pregnancy.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:36

Enthalten in:

The Canadian journal of cardiology - 36(2020), 7 vom: 04. Juli, Seite 1011-1021

Sprache:

Englisch

Beteiligte Personen:

D'Souza, Rohan D [VerfasserIn]
Silversides, Candice K [VerfasserIn]
Tomlinson, George A [VerfasserIn]
Siu, Samuel C [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Review

Anmerkungen:

Date Completed 18.05.2021

Date Revised 18.05.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.cjca.2020.02.079

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM31081975X