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Ebook ABC of antenatal care (4/E): Part 2

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Ebook ABC of antenatal care (4/E): Part 2

8 Antenatal medical and surgical problemsPregnant women are usually young and fit. They rarely have chronic medical conditions bill when they do, thos

Ebook ABC of antenatal care (4/E): Part 2se in charge ot antenatal care need to consider how the disease might affect pregnancy anil how pregnancy might affect the disease.Heart diseaseMost h

eart disease in women of childbearing age is rheumatic in origin despile the recent gieal reduction in the prevalence of rheumatic fever. Beller livin Ebook ABC of antenatal care (4/E): Part 2

g conditions in ihe UK and ihe more prompt treatment of streptococcal sore throats with Itnlibioliis in I'hildhiXid have reduced lheuinalic damage Io

Ebook ABC of antenatal care (4/E): Part 2

die heart valves and myocardium. An increasing proportion of piegtianl women have congenital heart lesions dial have been treated previously.Ptegnancy

8 Antenatal medical and surgical problemsPregnant women are usually young and fit. They rarely have chronic medical conditions bill when they do, thos

Ebook ABC of antenatal care (4/E): Part 2, slaying steady until labour, when it increases further. 1 his increased cardiac work cannot be done as effectively by a damaged bead; if die heal I

is compromised a woman would be wise to avoid other increased loads dial might piecipilale cardiac failure. The most frequently encountered arc:Box 8. Ebook ABC of antenatal care (4/E): Part 2

1 Problem diseases in pregnancy•Heart disease•Diabetes•' I hyi I lid disease•Epilepsy•Jaundice•Anaemia•I l.temoglobimipadiies•Urinary tract infection•

Ebook ABC of antenatal care (4/E): Part 2

HIV infection•Psychiatric changes and diseases•Household work•Paid work outside the home•Care Ilf Ollier family meiulierx•Pro-eclampsia•Anaemia•Recrud

8 Antenatal medical and surgical problemsPregnant women are usually young and fit. They rarely have chronic medical conditions bill when they do, thos

Ebook ABC of antenatal care (4/E): Part 2 retraction up to a litre of blood tall be swiftly shunted from the uterine wins into the general venous system.Rheumatic heart diseaseTire commonest

single tardiac lesion found in women of ibis age group is rheumatic mitral stenosis, sometimes accompanied by the after effects of rheumatic myocardit Ebook ABC of antenatal care (4/E): Part 2

is. The commonest complication of overload is pulmonary oedema in late pregnancy or immediately after delivery. Right sided cattliac failurc may occur

Ebook ABC of antenatal care (4/E): Part 2

but is less common.Caidiomyopathy of pregnancy occurs mostly post |Kirliiin but occasionally in late pregnancy, There is no obvious predtsposing caus

8 Antenatal medical and surgical problemsPregnant women are usually young and fit. They rarely have chronic medical conditions bill when they do, thos

Ebook ABC of antenatal care (4/E): Part 2ses uf lieatt disease include diytutoxkusis and cotouaiy surety diseaseCongenital lesionslhe most serious of the congenital lesions in pregnancy arc t

hose accomfxinietl by shunts.•Women with Eisenmenger’s syndrome tlo parlir iilariy badly in pregnancy, especially those with severe pulmonary hyperten Ebook ABC of antenatal care (4/E): Part 2

sion, which leads to a right III left shunt.•Tetralogy of Eallot has a lower risk of cardiac failure because there is less resistance at the pulmonary

Ebook ABC of antenatal care (4/E): Part 2

valve regulating right ventricular outflow.•Artificial heart valves arc now present in an increasing number of women who become pregnant. Commonly th

8 Antenatal medical and surgical problemsPregnant women are usually young and fit. They rarely have chronic medical conditions bill when they do, thos

Ebook ABC of antenatal care (4/E): Part 2 of teratogenesis in earlyTable 8.1 Modified New York Heart Association’s classification of exercise toleranceSymptoms of cardiac insufficiencyLimitat

ion of activities1NoneNone Ebook ABC of antenatal care (4/E): Part 2

8 Antenatal medical and surgical problemsPregnant women are usually young and fit. They rarely have chronic medical conditions bill when they do, thos

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