Controversies in Pregnancy and Congenital Heart Disease
Corresponding Author
Lorna Swan MD
Department of Cardiology, Western Infirmary, Glasgow, UK;
The Adult Congenital Heart Programme, Royal Brompton Hospital/National Heart & Lung Institute, Imperial College, London, UK
Lorna Swan, MD, Adult Congenital Heart Programme, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. Tel: (+44) 20-7351-8227; Fax: (+44) 20-7351-8629; E-mail: [email protected]Search for more papers by this authorMartin Lupton MD
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
Search for more papers by this authorJohn Anthony MD
Department of Obstetrics & Gynecology, University of Cape Town, South Africa;
Search for more papers by this authorSteve M. Yentis MBBS
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
Magill Department of Anesthesia, Intensive Care & Pain Management, Chelsea & Westminster Hospital, London, UK;
Search for more papers by this authorPhilip J. Steer MD
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
Search for more papers by this authorMichael A. Gatzoulis MD
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
The Adult Congenital Heart Programme, Royal Brompton Hospital/National Heart & Lung Institute, Imperial College, London, UK
Search for more papers by this authorCorresponding Author
Lorna Swan MD
Department of Cardiology, Western Infirmary, Glasgow, UK;
The Adult Congenital Heart Programme, Royal Brompton Hospital/National Heart & Lung Institute, Imperial College, London, UK
Lorna Swan, MD, Adult Congenital Heart Programme, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. Tel: (+44) 20-7351-8227; Fax: (+44) 20-7351-8629; E-mail: [email protected]Search for more papers by this authorMartin Lupton MD
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
Search for more papers by this authorJohn Anthony MD
Department of Obstetrics & Gynecology, University of Cape Town, South Africa;
Search for more papers by this authorSteve M. Yentis MBBS
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
Magill Department of Anesthesia, Intensive Care & Pain Management, Chelsea & Westminster Hospital, London, UK;
Search for more papers by this authorPhilip J. Steer MD
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
Search for more papers by this authorMichael A. Gatzoulis MD
High-Risk Obstetrics Unit, Chelsea & Westminster Hospital and Imperial College, London, UK;
The Adult Congenital Heart Programme, Royal Brompton Hospital/National Heart & Lung Institute, Imperial College, London, UK
Search for more papers by this authorABSTRACT
As increasing numbers of children with congenital heart disorders reach adulthood, the family physician, cardiologist, and obstetrician will increasingly be called upon to give advice regarding the safety of pregnancy. This need has been further highlighted by the recognition that maternal mortality associated with cardiac disease is rising. Unfortunately, this field of practice remains relatively “evidence-sparse” with many management decisions being guided by anecdote and “best guess” common sense. Not surprisingly, this results in many fundamental controversies over the optimal care these patients should receive. This article highlights, through the use of case histories, some of these contentious areas, reflecting the different manifestations of congenital maternal cardiac disease and highlighting the limitations of our knowledge.
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