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Cardiovascular Medications in Pregnancy

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1. Use of Medication for Cardiovascular Disease During Pregnancy: JACC State-of-the-Art Review. (PubMed)

Use of Medication for Cardiovascular Disease During Pregnancy: JACC State-of-the-Art Review. Cardiovascular disease complicating pregnancy is rising in prevalence secondary to advanced maternal age, cardiovascular risk factors, and the successful management of congenital heart disease conditions. The physiological changes of pregnancy may alter drug properties affecting both mother and fetus. Familiarity with both physiological and pharmacological attributes is key for the successful management (...) of pregnant women with cardiac disease. This review summarizes the published data, available guidelines, and recommendations for use of cardiovascular medications during pregnancy. Care of the pregnant woman with cardiovascular disease requires a multidisciplinary team approach with members from cardiology, maternal fetal medicine, anesthesia, and nursing.Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

2019 Journal of the American College of Cardiology

2. Management of Cardiovascular Diseases during Pregnancy

pregnancy Cardiac medication before pregnancy , Maternal decline in cardiac output during pregnancy Cyanosis (O 2 saturation <90%) , Abnormal uteroplacental Doppler flow Natriuretic peptide levels (NT-proBNP >128 pg/mL at 20 weeks predictive of event later in pregnancy) , Smoking history Mechanical valve prosthesis , Repaired or unrepaired cyanotic heart disease Predictors of maternal cardiovascular events Predictors of neonatal events Prior cardiac event (heart failure, transient ischaemic attack (...) Management of Cardiovascular Diseases during Pregnancy We use cookies to enhance your experience on our website. By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy | European Heart Journal | Oxford Academic Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term Close search filter search input Article Navigation Close

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2018 European Society of Cardiology

3. Pre-pregnancy cardiovascular indices and birth outcomes of subsequent pregnancies: A "sequential stress test" revealing hidden cardiovascular weakness? (PubMed)

Pre-pregnancy cardiovascular indices and birth outcomes of subsequent pregnancies: A "sequential stress test" revealing hidden cardiovascular weakness? 29476643 2019 02 26 2019 02 26 1471-0528 125 9 2018 08 BJOG : an international journal of obstetrics and gynaecology BJOG Pre-pregnancy cardiovascular indices and birth outcomes of subsequent pregnancies: a 'sequential stress test' revealing hidden cardiovascular weakness? 1135 10.1111/1471-0528.15181 Matsubara S S Department of Obstetrics (...) and Gynaecology, Jichi Medical University, Tochigi, Japan. eng Journal Article Comment 2018 04 11 England BJOG 100935741 1470-0328 AIM IM BJOG. 2018 Aug;125(9):1127-1134 29377552 Adult Cardiorespiratory Fitness Coronary Vessels Exercise Test Female Hemodynamics Humans Parturition Pregnancy Young Adult 2018 2 25 6 0 2019 2 27 6 0 2018 2 25 6 0 ppublish 29476643 10.1111/1471-0528.15181

2018 BJOG

4. Hypertensive pregnancy disorders increase the risk of maternal cardiovascular disease after adjustment for cardiovascular risk factors. (PubMed)

risk factors measured after pregnancy.A total of 20,075 women with a first delivery registered in the Medical Birth Registry of Norway (1980-2003) participated in Cohort of Norway (CONOR) health surveys a mean (standard deviation) of 10.7 (5.5) years after delivery. They were then followed (median 11.4 years) for an incident fatal or non-fatal CVD event through linkage to the Cardiovascular Disease in Norway (CVDNOR) database and the Norwegian Cause of Death Registry. Hypertensive pregnancy (...) Hypertensive pregnancy disorders increase the risk of maternal cardiovascular disease after adjustment for cardiovascular risk factors. Hypertensive pregnancy disorders are associated with subsequent cardiovascular disease (CVD), but the extent to which this association is explained by shared risk factors is unknown. We aimed to evaluate whether hypertensive pregnancy disorder in first pregnancy is associated with increased subsequent risk of maternal CVD after adjustment for established CVD

2019 International journal of cardiology

5. Cardiovascular Medications in Pregnancy

Cardiovascular Medications in Pregnancy Cardiovascular Medications in Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Cardiovascular Medications in Pregnancy Cardiovascular Medications in Pregnancy Aka: Cardiovascular Medications in Pregnancy , Anti-Arrhythmic Medications in Pregnancy II. Background Pregnancy Categories will be replaced on medication bottles with specific warnings and precautions by 2020 in U.S. Although are no longer designated, they are included here As of 2018, succinct guidance (to replace ABCDX) on specific drugs in pregnancy is lacking III. Class B: No risk in controlled animal studies s

2018 FP Notebook

6. Harnessing the Power of Pregnancy and Pregnancy-Related Events to Predict Cardiovascular Disease in Women (PubMed)

Harnessing the Power of Pregnancy and Pregnancy-Related Events to Predict Cardiovascular Disease in Women 28153994 2018 10 30 2018 11 13 1524-4539 135 6 2017 02 07 Circulation Circulation Harnessing the Power of Pregnancy and Pregnancy-Related Events to Predict Cardiovascular Disease in Women. 590-592 10.1161/CIRCULATIONAHA.117.026890 Sanghavi Monika M From the Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (M.S (...) .); and Cardiovascular Division, University of California San Francisco (N.I.P.). monsanghavi@gmail.com. Parikh Nisha I NI From the Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (M.S.); and Cardiovascular Division, University of California San Francisco (N.I.P.). eng R21 HL115398 HL NHLBI NIH HHS United States Editorial Comment United States Circulation 0147763 0009-7322 AIM IM Circulation. 2017 Feb 7;135(6):578-589 28153993 Circulation. 2017 Feb

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2017 Circulation

7. Does pregnancy complication history improve cardiovascular disease risk prediction? Findings from the HUNT study in Norway. (PubMed)

Does pregnancy complication history improve cardiovascular disease risk prediction? Findings from the HUNT study in Norway. To evaluate whether history of pregnancy complications [pre-eclampsia, gestational hypertension, preterm delivery, or small for gestational age (SGA)] improves risk prediction for cardiovascular disease (CVD).This population-based, prospective cohort study linked data from the HUNT Study, Medical Birth Registry of Norway, validated hospital records, and Norwegian Cause (...) of Death Registry. Using an established CVD risk prediction model (NORRISK 2), we predicted 10-year risk of CVD (non-fatal myocardial infarction, fatal coronary heart disease, and non-fatal or fatal stroke) based on established risk factors (age, systolic blood pressure, total and HDL-cholesterol, smoking, anti-hypertensives, and family history of myocardial infarction). We evaluated whether adding pregnancy complication history improved model fit, calibration, discrimination, and reclassification

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2018 European Heart Journal

8. Life Course Trajectories of Cardiovascular Risk Factors in Women With and Without Hypertensive Disorders in First Pregnancy: The HUNT Study in Norway (PubMed)

women. Methods and Results We linked information on cardiovascular risk factors from the population-based HUNT (Nord-Trøndelag Health Study) surveys with pregnancy information from the Medical Birth Registry of Norway. Trajectories of cardiovascular risk factors were constructed for 22 308 women with a normotensive first pregnancy; 1092 with preeclampsia, and 478 with gestational hypertension in first pregnancy. Already before first pregnancy, women with preeclampsia in their first pregnancy had (...) Life Course Trajectories of Cardiovascular Risk Factors in Women With and Without Hypertensive Disorders in First Pregnancy: The HUNT Study in Norway Background Women with hypertensive pregnancy disorders have adverse levels of cardiovascular risk factors. It is unclear how this adverse risk factor profile evolves during adult life. We compared life course trajectories of cardiovascular risk factors in women with preeclampsia or gestational hypertension in their first pregnancy to normotensive

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2018 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

9. Cardiovascular Complications in Pregnancy: It Is Time for Action. (PubMed)

Cardiovascular Complications in Pregnancy: It Is Time for Action. 29459362 2018 04 29 1524-4539 137 12 2018 Mar 20 Circulation Circulation Cardiovascular Complications in Pregnancy: It Is Time for Action. 1213-1215 10.1161/CIRCULATIONAHA.117.031592 Graves Cornelia R CR Tennesee Maternal Fetal Medicine, Nashville (C.R.G.) cgraves@tnmfm.com stacy.davis1@ascension.org. Department of Obstetrics and Gynecology (C.R.G.). Collaborative Perinatal Cardiac Center, Nashville, TN (C.R.G., S.F.D (...) 0147763 0009-7322 cardiovascular disease pregnancy prevention women 2018 2 21 6 0 2018 2 21 6 0 2018 2 21 6 0 ppublish 29459362 CIRCULATIONAHA.117.031592 10.1161/CIRCULATIONAHA.117.031592

2018 Circulation

10. Maternal cardiovascular hemodynamics in normotensive versus preeclamptic pregnancies: a prospective longitudinal study using a noninvasive cardiac system (NICaS™). (PubMed)

Maternal cardiovascular hemodynamics in normotensive versus preeclamptic pregnancies: a prospective longitudinal study using a noninvasive cardiac system (NICaS™). Preeclampsia is among the most common medical complications of pregnancy. The clinical utility of invasive hemodynamic monitoring in preeclampsia (e.g., Swan-Ganz catheter) is controversial. Thoracic impedance cardiography (TIC) and Doppler echocardiography are noninvasive techniques but they both have important limitations. NICaS™ (...) (NI Medical, PetachTikva, Israel) is a noninvasive cardiac system for determining cardiac output (CO) that utilizes regional impedance cardiography (RIC) by noninvasively measuring the impedance signal in the periphery. It outperformed any other impedance cardiographic technology and was twice as accurate as TIC.We used the NICaS™ system to compare the hemodynamic parameters of women with severe preeclampsia (PET group, n = 17) to a cohort of healthy normotensive pregnant women with a singleton

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2018 BMC Pregnancy and Childbirth

11. The effect of pregnancy on the long-term risk of graft loss, cardiovascular disease and death in kidney transplanted women in Norway: a retrospective cohort study. (PubMed)

, with graft loss, cardiovascular disease, and death as outcomes. Baseline characteristics for all women were ascertained at first transplantation, with information about exposure, outcomes, and potential confounders collected from medical records. To account for changes in pregnancy status, data were analyzed using proportional hazard Cox regression with pregnancy status as a time-dependent covariate changing at the time of pregnancy.Of 650 women studied, 124 had a pregnancy after kidney transplantation (...) The effect of pregnancy on the long-term risk of graft loss, cardiovascular disease and death in kidney transplanted women in Norway: a retrospective cohort study. Kidney transplant recipients have now conceived for almost 50 years. Nevertheless, few studies have evaluated long-term health outcomes for kidney transplanted women after pregnancies.We conducted a retrospective cohort study of all Norwegian women receiving a kidney transplant before the age of 50 years between 1969 and 2013

2018 Transplantation

12. Physical Exercise Cardiovascular Adaptation Monitoring in Pregnancy (PE-CAMP Study)

Physical Exercise Cardiovascular Adaptation Monitoring in Pregnancy (PE-CAMP Study) Physical Exercise Cardiovascular Adaptation Monitoring in Pregnancy (PE-CAMP Study) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Physical Exercise Cardiovascular Adaptation Monitoring in Pregnancy (PE-CAMP Study) (PE-CAMP) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03748888 Recruitment Status : Recruiting First Posted : November 21

2018 Clinical Trials

13. Hypertensive Disorders of Pregnancy and 10-Year Cardiovascular Risk Prediction. (PubMed)

Hypertensive Disorders of Pregnancy and 10-Year Cardiovascular Risk Prediction. Hypertensive disorders of pregnancy (HDP) affect 10% to 15% of women and are associated with a 2-fold increased risk of cardiovascular disease (CVD).This study sought to determine whether inclusion of HDP in an established CVD risk score improves prediction of CVD events in women.The analysis comprised 106,230 ≤10-year observations contributed by 67,406 women, age ≥40 years, free of prior CVD, with data available (...) on model covariates in the Nurses' Health Study II. Participants were followed up for confirmed myocardial infarction, fatal coronary heart disease, or stroke from 1989 to 2013. We fit an established CVD risk prediction model (Model A: age, total cholesterol and high-density lipoprotein cholesterol, systolic blood pressure, antihypertensive medication use, current smoking, diabetes mellitus) and compared it to the same model plus HDP and parity (Model B); Cox proportional hazards models were used

2018 Journal of the American College of Cardiology

14. Hypertension in pregnancy: diagnosis and management

is it for? 5 Recommendations 6 1.1 Reducing the risk of hypertensive disorders in pregnancy 6 1.2 Assessment of proteinuria in hypertensive disorders of pregnancy 8 1.3 Management of chronic hypertension in pregnancy 9 1.4 Management of gestational hypertension 13 1.5 Management of pre-eclampsia 17 1.6 Fetal monitoring 24 1.7 Intrapartum care 26 1.8 Medical management of severe hypertension, severe pre-eclampsia or eclampsia in a critical care setting 27 1.9 Antihypertensive treatment during the postnatal (...) of birth 46 Antihypertensive treatment during the postnatal period, including during breastfeeding 48 Risk of recurrence of hypertensive disorders of pregnancy and long-term cardiovascular disease 49 Context 50 Hypertension in pregnancy: diagnosis and management (NG133) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 54Finding more information and resources 52 Update information 53 Hypertension in pregnancy

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

15. Cardiovascular Diseases during Pregnancy

Thorne et al. 73 LVEF¼ left ventricular ejection fraction; NYHA¼ New York Heart Association; WHO¼ World Health Organization. Table 6 Modi?ed WHO classi?cation of maternal cardiovascular risk: principles Risk class Risk of pregnancy by medical condition I No detectable increased risk of maternal mortality and no/mild increase in morbidity. II Small increased risk of maternal mortality or moderate increase in morbidity. III Signi?cantly increased risk of maternal mortality or severe morbidity. Expert (...) Cardiovascular Diseases during Pregnancy ESC GUIDELINES ESC Guidelines on the management of cardiovascular diseases during pregnancy The Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC) Endorsed by the European Society of Gynecology (ESG), the Association for European Paediatric Cardiology (AEPC), and the German Society for Gender Medicine (DGesGM) Authors/Task Force Members: Vera Regitz-Zagrosek (Chairperson) (Germany

2011 European Society of Cardiology

16. Hypertensive Disorders in Pregnancy and the Risk of Subsequent Cardiovascular Disease. (PubMed)

Hypertensive Disorders in Pregnancy and the Risk of Subsequent Cardiovascular Disease. Hypertensive disorders in pregnancy (HDP) have been shown to predict later risk of cardiovascular disease (CVD). However, previous studies have not accounted for subsequent pregnancies and their complications, which are potential confounders and intermediates of this association.A cohort of 146 748 women with a first pregnancy was constructed using the Clinical Practice Research Datalink. HDP was defined (...) using diagnostic codes, elevated blood pressure readings, or new use of an anti-hypertensive drug between 18 weeks' gestation and 6 weeks post-partum. The study outcomes were incident CVD and hypertension. Marginal structural Cox models (MSM) were used to account for time-varying confounders and intermediates. Time-fixed exposure defined at the first pregnancy was used in secondary analyses.A total of 997 women were diagnosed with incident CVD, and 6812 women were diagnosed with hypertension

2017 Paediatric and perinatal epidemiology

17. All Hypertensive Disorders of Pregnancy Increase the Risk of Future Cardiovascular Disease. (PubMed)

All Hypertensive Disorders of Pregnancy Increase the Risk of Future Cardiovascular Disease. Hypertensive disorders of pregnancy are associated with vascular dysfunction in the pregnancy and an increased risk of long-term cardiovascular disease (CVD) in the mother. What remains to be understood is whether the length, severity of the disease, the treatment of hypertension in pregnancy, or the subtype of hypertensive disorders of pregnancy are significant predictors of future CVD. We undertook (...) who presented with gestational hypertension were at greater risk of future hypertension and ischemic heart disease compared with the women who were diagnosed with preeclampsia. There was no significant difference between the women who were treated with antihypertensive medication and the women who did not receive antihypertensive medication or the duration of hypertensive disorders of pregnancy and future admission for CVD, although severity of hypertension tracked with increased risk of future

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2017 Hypertension

18. Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood: Prospective and Sibling Studies in the HUNT Study (Nord-Trøndelag Health Study) in Norway. (PubMed)

Hypertension in Pregnancy and Offspring Cardiovascular Risk in Young Adulthood: Prospective and Sibling Studies in the HUNT Study (Nord-Trøndelag Health Study) in Norway. Women with hypertensive disorders in pregnancy are at increased lifetime risk for cardiovascular disease. We examined the offspring's cardiovascular risk profile in young adulthood and their siblings' cardiovascular risk profile. From the HUNT study (Nord-Trøndelag Health Study) in Norway, 15 778 participants (mean age: 29 (...) years), including 210 sibling groups, were linked to information from the Medical Birth Registry of Norway. Blood pressure, anthropometry, serum lipids, and C-reactive protein were assessed. Seven hundred and six participants were born after exposure to maternal hypertension in pregnancy: 336 mothers had gestational hypertension, 343 had term preeclampsia, and 27 had preterm preeclampsia. Offspring whose mothers had hypertension in pregnancy had 2.7 (95% confidence interval, 1.8-3.5) mm Hg higher

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2017 Hypertension

19. Pregnancy and Subsequent Glucose Intolerance in Women of Childbearing Age: Heeding the Early Warning Signs for Primary Prevention of Cardiovascular Disease in Women (PubMed)

Pregnancy and Subsequent Glucose Intolerance in Women of Childbearing Age: Heeding the Early Warning Signs for Primary Prevention of Cardiovascular Disease in Women 29049465 2019 01 15 2019 01 15 2168-6114 177 12 2017 12 01 JAMA internal medicine JAMA Intern Med Pregnancy and Subsequent Glucose Intolerance in Women of Childbearing Age: Heeding the Early Warning Signs for Primary Prevention of Cardiovascular Disease in Women. 1742-1744 10.1001/jamainternmed.2017.4768 Gunderson Erica P EP (...) Cardiovascular and Metabolic Conditions Section, Division of Research, Kaiser Permanente Northern California, Oakland. Jaffe Marc G MG Department of Endocrinology, Kaiser Permanente South San Francisco Medical Center, South San Francisco, California. Department of Medicine, University of California, San Francisco. eng R01 DK106201 DK NIDDK NIH HHS United States Journal Article Comment United States JAMA Intern Med 101589534 2168-6106 AIM IM JAMA Intern Med. 2017 Dec 1;177(12):1735-1742 29049820

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2017 JAMA Internal Medicine

20. Comparing Two Medical Treatments for Early Pregnancy Failure.

Comparing Two Medical Treatments for Early Pregnancy Failure. Comparing Two Medical Treatments for Early Pregnancy Failure. - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Comparing Two Medical Treatments (...) University Collaborators: Innovatiefonds Zorgverzekeraars Canisius-Wilhelmina Hospital Information provided by (Responsible Party): Radboud University Study Details Study Description Go to Brief Summary: This study aims to compare whether a combination of two drugs (Mifepristone and misoprostol) are superior compared to using only one of these drugs (Misoprostol) as medical treatment for a miscarriage. Women in whom early pregnancy failure, 6-14 weeks postmenstrual, is ultrasonographically confirmed

2017 Clinical Trials

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