Key result
Preconception counseling and meticulous multidisciplinary management improve outcomes for pregnant patients with congenital heart disease, though certain high-risk conditions warrant pregnancy avoidance.
Preconception counseling and meticulous multidisciplinary management are essential for pregnant patients with congenital heart disease, while certain high-risk conditions warrant advising against pregnancy.
Supports preconception counseling in congenital heart disease; extends evidence synthesis on high-risk pregnancy avoidance.
Care of pregnant patients with congenital heart disease requires understanding of the specific congenital defect, the nature of previous surgical correction, and the residua and sequelae. General risks and principles can be adduced in management decisions. In addition, lesion- and patient-specific details are important. There are only a few conditions that place patients at a high enough risk to advise that pregnancy be avoided under all circumstances (pulmonary vascular obstructive disease, Marfan syndrome with dilated aortic root, severe aortic stenosis, and severe systemic ventricular dysfunction). Preconception counseling, optimization of status, and meticulous multidisciplinary management during pregnancy and the postpartum period will improve outcomes.
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Colman et al. (2000) conducted a review in Congenital heart disease in pregnancy. Preconception counseling and meticulous multidisciplinary management improve outcomes for pregnant patients with congenital heart disease, though certain high-risk conditions warrant pregnancy avoidance.
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