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English K, Frise C, Trinder J, Cauldwell M, Simpson M, Adamson D, Elton C, Burns G, Choudhary M, Nathanson M, Robert L, Moore J, O'Brien P, Pundir J. Best practice recommendations for medically assisted reproduction in patients with known cardiovascular disease or at high risk of cardiovascular disease. HUM FERTIL 2024; 27:2278295. [PMID: 38196173 DOI: 10.1080/14647273.2023.2278295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 01/11/2024]
Abstract
Increasing numbers of people are seeking assisted conception. In people with known cardiac disease or risk factors for cardiac disease, assisted conception may carry increased risks during treatment and any subsequent pregnancy. These risks should be assessed, considered and minimized prior to treatment.
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Affiliation(s)
- Kate English
- Department of Congenital Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Charlotte Frise
- Department of Obstetrics, Queen Charlotte's and Chelsea Hospital, London, UK
| | | | | | | | - Dawn Adamson
- Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Chris Elton
- Department of Anaesthesia, Leicester Royal Infirmary, Leicester, UK
| | | | - Meenakshi Choudhary
- Newcastle Fertility Centre at Life, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Mike Nathanson
- Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Leema Robert
- Department of Clinical Genetics, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Jim Moore
- Department of Primary Care, NHS Gloucestershire Clinical Commissioning Group, Brockworth, UK
| | - Pat O'Brien
- Department of Obstetrics, University College London, London, UK
| | - Jyotsna Pundir
- Reproductive Medicine, St Bartholomew's Hospital, London, UK
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Joseph KS, Lisonkova S, Boutin A, Muraca GM, Razaz N, John S, Sabr Y, Chan WS, Mehrabadi A, Brandt JS, Schisterman EF, Ananth CV. Why improved surveillance is critical for reducing maternal deaths in the United States: a response to the American College of Obstetricians and Gynecologists. Am J Obstet Gynecol 2024:S0002-9378(24)00581-7. [PMID: 38729595 DOI: 10.1016/j.ajog.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 05/02/2024] [Accepted: 05/05/2024] [Indexed: 05/12/2024]
Affiliation(s)
- K S Joseph
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, Canada; School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
| | - Sarka Lisonkova
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, Canada; School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Amélie Boutin
- Faculty of Medicine, Department of Pediatrics, Université Laval and Centre Hospitalier Universitaire de Québec-Université Laval Research Center, Québec City, Canada
| | - Giulia M Muraca
- Departments of Obstetrics and Gynecology and Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Neda Razaz
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Sid John
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, Canada
| | - Yasser Sabr
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, Canada
| | - Wee-Shian Chan
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Azar Mehrabadi
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Justin S Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY
| | - Enrique F Schisterman
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Cande V Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Cardiovascular Institute of New Jersey and Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ; Environmental and Occupational Health Sciences Institute, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ
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3
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DeFilippis EM, Bhagra C, Casale J, Ging P, Macera F, Punnoose L, Rasmusson K, Sharma G, Sliwa K, Thorne S, Walsh MN, Kittleson MM. Cardio-Obstetrics and Heart Failure: JACC: Heart Failure State-of-the-Art Review. JACC. HEART FAILURE 2023; 11:1165-1180. [PMID: 37678960 DOI: 10.1016/j.jchf.2023.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/26/2023] [Accepted: 07/05/2023] [Indexed: 09/09/2023]
Abstract
Heart failure and cardiomyopathy are significant contributors to pregnancy-related deaths, as maternal morbidity and mortality have been increasing over time. In this setting, the role of the multidisciplinary cardio-obstetrics team is crucial to optimizing maternal, obstetrical and fetal outcomes. Although peripartum cardiomyopathy is the most common cardiomyopathy experienced by pregnant individuals, the hemodynamic changes of pregnancy may unmask a pre-existing cardiomyopathy leading to clinical decompensation. Additionally, there are unique management considerations for women with pre-existing cardiomyopathy as well as for those women with advanced heart failure who may be on left ventricular assist device support or have undergone heart transplantation. The purpose of this review is to discuss: 1) preconception counseling; 2) risk stratification and management strategies for pregnant women extending to the postpartum "fourth trimester" with pre-existing heart failure or "pre-heart failure;" 3) the safety of heart failure medications during pregnancy and lactation; and 4) management of pregnancy for women on left ventricular assist device support or after heart transplantation.
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Affiliation(s)
- Ersilia M DeFilippis
- Division of Cardiology, NewYork-Presbyterian Columbia University Irving Medical Center, New York, New York, USA
| | - Catriona Bhagra
- Department of Cardiology, Cambridge University and Royal Papworth NHS Foundation Trusts, Cambridge, United Kingdom
| | - Jillian Casale
- Department of Pharmacy Services, Cooperman Barnabas Medical Center, Livingston, New Jersey, USA
| | - Patricia Ging
- Department of Pharmacy, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Francesca Macera
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milan, Italy; Department of Cardiology, Cliniques Universitaires de Bruxelles - Hôpital Erasme, Brussels, Belgium
| | - Lynn Punnoose
- Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kismet Rasmusson
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, Utah, USA
| | - Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Karen Sliwa
- Cape Heart Institute, Department of Medicine, Division of Cardiology, Faculty of Health Sciences, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Sara Thorne
- Division of Cardiology, Pregnancy & Heart Disease Program, Mount Sinai Hospital & University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Michelle M Kittleson
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
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