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Obstetric cardiology 

Obstetric cardiology
Chapter:
Obstetric cardiology
Author(s):

Dr John Fryearson

and Dr Dawn Adamson

DOI:
10.1093/med/9780199594764.003.0025
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date: 22 August 2019

The management of cardiac patients who are or want to become pregnant is a complex and challenging field. Each woman's pregnancy is individual, physicians often have limited experience in this area, and there is a paucity of data to call upon for guidance. It involves a complex multi-disciplinary approach, yet despite huge advances in cardiology over the last few decades, maternal death from cardiac causes continues to rise and is now the UK's leading cause of death in pregnant women.

Clinical trials in pregnant women are few and far between, whilst large randomized trials are virtually non-existent. The literature is therefore predominantly experience in the form of single or multiple case reports, registries, and views of those authors who specialize in this area. There is no doubt that in the field of obstetric cardiology, these papers add value to an area with limited data; however, they are clearly open to serious scientific flaws and prone to selection bias.

The landmark papers selected here have been chosen to reflect each area of cardiovascular disease which affects pregnant women, for example ischaemic heart disease (IHD), valvular heart disease, etc. They have been chosen because they are the papers which have influenced and continue to influence the management of women, whether in giving the most accurate pre-pregnancy counselling or in the actual management of the condition.

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