| Table 3: |
|
Maternal
Cardiac Lesions and Risk of Cardiac Complications During Pregnancy
|
| Low
Risk |
- Atrial septal defect
- Ventricular septal
defect
- Patent ductus arteriosus
- Asymptomatic AS
with low mean gradient (<50 mm Hg) and normal LV function (EF>50%)
- AR with normal
LV function and NYHA class I or II
- MVP (isolated or
with mild/moderate MR and normal LV function)
- MR with normal
LV function and NYHA class I or II
- Mild/moderate MS
(MVA >1.5 cm2, mean gradient <5 mm Hg) without severe
pulmonary hypertension
- Mild/moderate PS
- Repaired acyanotic
congenital heart disease without residual cardiac dysfunction
|
| Intermediate
Risk |
- Large left to right
shunt
- Coarctation of
the aorta
- Marfan's syndrome
with a normal aortic root
- Moderate/severe
MS
- Mild/moderate AS
- Severe PS
- History of prior
peripartum cardiomyopathy with no residual ventricular dysfunction
|
| High
Risk |
- Eisenmenger's syndrome
- Severe pulmonary
hypertension
- Complex cyanotic
heart disease (TOF, Ebstein's anomaly, TA, TGA, tricuspid atresia)
- Marfan's syndrome
with aortic root or valve involvement
- Severe AS with
or without symptoms
- Aortic and/or mitral
valve disease with moderate/severe LV dysfunction (EF<40%)
- NYHA class III
to IV symptoms associated with any valvular disease or with cardiomyopathy
of any etiology
- History of peripartum
cardiomyopathy with persistent LV dysfunction
|
| AS
= aortic stenosis, LV = left ventricle, EF = ejection fraction, AR = aortic
regurgitation, NYHA = New York Heart Association, MVP = mitral valve prolapse,
MS = mitral stenosis, MVA = mitral valve area, PS = pulmonary stenosis,
TOF = tetralogy of Falot, TA = Truncus arteriosus, TGA = transposition of
the great arteries |
| Adapted
from reference 3. |