Cardiac medications in obstetric patients.
Female
Humans
Pregnancy
Antihypertensive Agents
/ therapeutic use
Aspirin
/ therapeutic use
Hypertension
/ drug therapy
Labetalol
/ therapeutic use
Platelet Aggregation Inhibitors
/ therapeutic use
Pre-Eclampsia
/ drug therapy
Cardiovascular Agents
/ adverse effects
Hematologic Agents
/ adverse effects
Journal
Current opinion in cardiology
ISSN: 1531-7080
Titre abrégé: Curr Opin Cardiol
Pays: United States
ID NLM: 8608087
Informations de publication
Date de publication:
01 05 2023
01 05 2023
Historique:
medline:
6
4
2023
entrez:
5
4
2023
pubmed:
6
4
2023
Statut:
ppublish
Résumé
This review summarizes recent literature, updated safety data, and major clinical considerations for commonly used medications for arrhythmias, heart failure, hypertension, ischemic heart disease, and anticoagulation during pregnancy and lactation. Recent studies have shown a benefit to more aggressive treatment of mild chronic hypertension to a blood pressure goal of <140/90 with oral labetalol and nifedipine remaining first-line agents. Aspirin is now routinely used for preeclampsia prevention, while experience with other antiplatelet agents, such as purinergic receptor P2Y G protein-coupled 12 (P2Y12) inhibitors, continues to grow. Data on statin therapy are rapidly changing and recent studies suggest this class may not be associated with fetal harm and can be continued in select cases. As data regarding medication safety continues to evolve, a multidisciplinary team is needed for full consideration of maternal and fetal risks and benefits. Ongoing studies are needed to improve and expand our understanding of medication safety during pregnancy and lactation.
Identifiants
pubmed: 37016996
doi: 10.1097/HCO.0000000000001039
pii: 00001573-202305000-00016
doi:
Substances chimiques
Antihypertensive Agents
0
Aspirin
R16CO5Y76E
Labetalol
R5H8897N95
Platelet Aggregation Inhibitors
0
Cardiovascular Agents
0
Hematologic Agents
0
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
266-274Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
World Fertility and Family Planning 2020 Highlights. United Nations Department of Economic and Social Affairs [Internet]. [cited 2022 Dec 28]; Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/Aug/un_2020_worldfertilityfamilyplanning_highlights.pdf
Goyal N, Herrick JS, Son S, et al. Maternal cardiovascular complications at the time of delivery and subsequent re-hospitalization in the USA, 2010–16. Eur Heart J Qual Care Clin Outcomes 2019; 7:304–311.
Ruys TPE, Maggioni A, Johnson MR, et al. Cardiac medication during pregnancy, data from the ROPAC. Int J Cardiol 2014; 177:124–128.
Lippincott Williams & Wilkins, Briggs GG, Freeman RK, Yaffe SJ. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. 2012; 1728.
Pernia S, DeMaagd G. The new pregnancy and lactation labeling rule P T 2016; 41:713–715.
Lima FV, Yang J, Xu J, Stergiopoulos K. National trends and in-hospital outcomes in pregnant women with heart disease in the United States. Am J Cardiol 2017; 119:1694–1700.
Ghosh N, Luk A, Derzko C, et al. The acute treatment of maternal supraventricular tachycardias during pregnancy: a review of the literature. J Obstetr Gynaecol Canada 2011; 33:17–23.
Tamirisa KP, Elkayam U, Briller JE, et al. Arrhythmias in pregnancy. JACC: Clin Electrophysiol 2022; 8:120–135.
Saad AF, Monsivais L, Pacheco LD. Digoxin therapy of fetal superior ventricular tachycardia: are digoxin serum levels reliable? AJP Rep 2016; 6:272–276.
Chan V, Tse TF, Wong V. Transfer of digoxin across the placenta and into breast milk. BJOG: Int J Obstetr Gynaecol 1978; 85:605–609.
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J 2018; 39:3165–3241.
Park K, Bairey Merz CN, Bello NA, et al. Management of women with acquired cardiovascular disease from pre-conception through pregnancy and postpartum. J Am College Cardiol 2021; 77:1799–1812.
Teramo K, Benowitz N, Heymann MA, et al. Effects of lidocaine on heart rate, blood pressure, and electrocorticogram in fetal sheep. Am J Obstetr Gynecol 1974; 118:935–949.
Rotmensch HH, Elkayam U, Frishman W. Antiarrhythmic drug therapy during pregnancy. Ann Intern Med 1983; 98:487–497.
Page RL. Treatment of arrhythmias during pregnancy. Am Heart J 1995; 130:871–876.
Gudmundsson S, Gennser G, Marsal K. Effects of hydralazine on placental and renal circulation in preeclampsia. Acta Obstetricia et Gynecologica Scandinavica 1995; 74:415–418.
Canobbio MM, Warnes CA, Aboulhosn J, et al. Management of pregnancy in patients with complex congenital heart disease: a scientific statement for healthcare professionals from the American heart association. Circulation 2017; 135:50–87.
Davis MB, Arany Z, McNamara DM, et al. Peripartum cardiomyopathy. J Am College Cardiol 2020; 75:207–221.
Drugs and Lactation Database (LactMed) [Internet]. National Library of Medicine (US); 2006 [cited 2022 Dec 5]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/
Pieper PG. Use of medication for cardiovascular disease during pregnancy. Nat Rev Cardiol 2015; 12:718–729.
Bowen ME, Ray WA, Arbogast PG, et al. Increasing exposure to angiotensin-converting enzyme inhibitors in pregnancy. Am J Obstetr Gynecol 2008; 198:291.e1–291.e5.
Buawangpong N, Teekachunhatean S, Koonrungsesomboon N. Adverse pregnancy outcomes associated with first-trimester exposure to angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers: a systematic review and meta-analysis. Pharmacol Res Perspect 2020; 8:e00644.
Liszewski W, Boull C. Lack of evidence for feminization of males exposed to spironolactone in utero: a systematic review. J Am Acad Dermatol 2019; 80:1147–1148.
Riester A, Reincke M. Progress in primary aldosteronism: mineralocorticoid receptor antagonists and management of primary aldosteronism in pregnancy. Eur J Endocrinol 2015; 172:R23–30.
Collins R, Yusuf S, Peto R. Overview of randomised trials of diuretics in pregnancy. Br Med J (Clin Res Ed) 1985; 290:17–23.
Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022; 145:e876–e894.
Stapel B, Kohlhaas M, Ricke-Hoch M, et al. Low STAT3 expression sensitizes to toxic effects of β-adrenergic receptor stimulation in peripartum cardiomyopathy. Eur Heart J 2017; 38:349–361.
Fishburne JI, Meis PJ, Urban RB, et al. Vascular and uterine responses to dobutamine and dopamine in the gravid ewe. Am J Obstetr Gynecol 1980; 137:944–952.
van Nimwegen D, Dyer DC. The action of vasopressors on isolated uterine arteries. Am J Obstetr Gynecol 1974; 118:1099–1103.
Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135: e237–e260.
Tita AT, Szychowski JM, Boggess K, et al. Treatment for mild chronic hypertension during pregnancy. N Engl J Med 2022; 386:1781–1792.
Clinical Guidance for the Integration of the Findings of the Chronic Hypertension and Pregnancy (CHAP) Study. [Internet]. American College of Obstetrics and Gynecology Practice Advisory. 2022 [cited 2023 Jan 15]. Available from: https://www.acog.org/en/clinical/clinical-guidance/practice-advisory/articles/2022/04/clinical-guidance-for-the-integration-of-the-findings-of-the-chronic-hypertension-and-pregnancy-chap-study
Society for Maternal-Fetal Medicine; Publications Committee. Electronic address: pubs@smfm.org. Society for Maternal-Fetal Medicine Statement: Antihypertensive therapy for mild chronic hypertension in pregnancy-The Chronic Hypertension and Pregnancy trial. Am J Obstet Gynecol . 2022;227: B24-B27.
Clark SM, Dunn HE, Hankins GDV. A review of oral labetalol and nifedipine in mild to moderate hypertension in pregnancy. Semin Perinatol 2015; 39:548–555.
Davis MB, Arendt K, Bello NA, et al. Team-based care of women with cardiovascular disease from pre-conception through pregnancy and postpartum. J Am College Cardiol 2021; 77:1763–1777.
Easterling T, Mundle S, Bracken H, et al. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. The Lancet 2019; 394:1011–1021.
Davis RL, Eastman D, McPhillips H, et al. Risks of congenital malformations and perinatal events among infants exposed to calcium channel and beta-blockers during pregnancy. Pharmacoepidemiol Drug Saf 2011; 20:138–145.
Abalos E, Duley L, Steyn DW, Gialdini C. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 2018; 2018:CD002252.
Lydakis C, Lip GYH, Beevers M, Beevers DG. Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens 1999; 12:541–547.
Tanaka K, Tanaka H, Kamiya C, et al. Beta-blockers and fetal growth restriction in pregnant women with cardiovascular disease. Circ J 2016; 80:2221–2226.
Henderson JT, Vesco KK, Senger CA, et al. Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 [cited 2023 Jan 15]. (U.S. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews). Available from: http://www.ncbi.nlm.nih.gov/books/NBK574449/
Davidson K. Aspirin use to prevent preeclampsia and related morbidity and mortality: US preventive services task force recommendation statement. JAMA 2021; 326:1186–1191.
Nana M, Morgan H, Moore S, et al. Antiplatelet therapy in pregnancy: a systematic review. Pharmacol Res 2021; 168:105547.
Horlocker TT, Vandermeuelen E, Kopp SL, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American society of regional anesthesia and pain medicine evidence-based guidelines (Fourth Edition). Obstetric Anesthesia Digest 2019; 39:28–29.
Tello-Montoliu A, Seecheran NA, Angiolillo DJ. Successful pregnancy and delivery on prasugrel treatment: considerations for the use of dual antiplatelet therapy during pregnancy in clinical practice. J Thromb Thrombolysis 2013; 36:348–351.
Verbruggen M, Mannaerts D, Muys J, Jacquemyn Y. Use of ticagrelor in human pregnancy, the first experience. BMJ Case Rep 2015; bcr2015212217.
Winterfeld U, Allignol A, Panchaud A, et al. Pregnancy outcome following maternal exposure to statins: a multicentre prospective study. BJOG: Int J Obstetr Gynaecol 2013; 120:463–471.
Chang JC, Chen YJ, Chen IC, et al. Perinatal outcomes after statin exposure during pregnancy. JAMA Netw Open 2021; 4:e2141321.
Karalis DG, Hill AN, Clifton S, Wild RA. The risks of statin use in pregnancy: a systematic review. J Clin Lipidol 2016; 10:1081–1090.
Bateman BT, Hernandez-Diaz S, Fischer MA, et al. Statins and congenital malformations: cohort study. BMJ 2015; 350:h1035.
Grześk G, Dorota B, Wołowiec Ł, et al. Safety of PCSK9 inhibitors. Biomed Pharmacother 2022; 156:113957.
Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 143:e72–e227.
D'Souza R, Ostro J, Shah PS, et al. Anticoagulation for pregnant women with mechanical heart valves: a systematic review and meta-analysis. Eur Heart J 2017; 38:1509–1516.