Medical and Surgical Complications in Pregnancy
In which of the following heart diseases is maternal mortality during pregnancy is found to be the highest? (DNB, June 2012)
|A||Coarctation of aorta|
1. Pulmonary Hypertension Maternal mortality in the setting of severe pulmonary hypertension is high, and primary pulmonary hypertension is a contraindication to pregnancy.
2. Termination of pregnancy may be advisable in these circumstances to preserve the life of the mother.
3. In the Eisenmenger syndrome, i.e., the combination of pulmonary hypertension with right-to-left shunting due to congen-, ital abnormalities maternal and fetal death occur frequently.
4. Systemic hypotension may occur after blood loss, prolonged Valsalva maneuver, or regional anesthesia; sudden death secondarytol hypotension is a dreaded complication.
5. Management of these patients, is challenging, and invasive hemodynamic monitoring during labor and delivery is generally recommended.
6. In patients with pulmonary hypertension, vaginal delivery is test stressful hemodynamically than Cesarean section, which should be reserved for accepted obstetric indications.