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#Cardiology #Obstetrics and Gynecology #Pediatrics
The European Society of Cardiology (ESC) has published new guidelines on management of cardiovascular disease (CVD) in pregnancy online August 25, 2018 in the European Heart Journal. Some of the key recommendations include:
- In women with a moderate or high-risk of complications during pregnancy, pre-pregnancy counselling and management during pregnancy and around delivery should be performed in an expert center by a multidisciplinary team
- All women with congenital or other possibly genetic heart disease should be offered fetal echocardiography in weeks 19–22 of pregnancy.
- A delivery plan should be made between 20–30 weeks of pregnancy detailing induction, management of labor, delivery, and post-partum surveillance.
- Induction of labor should be considered at 40 weeks of gestation in all women with cardiac disease.
- Vaginal delivery is the first choice for the majority of patients.
- Indications for caesarean section are: Pre-term labor in patients on oral anticoagulants, aggressive aortic pathology, acute intractable heart failure and severe forms of pulmonary hypertension (including Eisenmenger’s syndrome)