Preparing the Heart for a New Baby: Management of Pregnancy in Heart Transplant Recipients.
Journal
Cardiology in review
ISSN: 1538-4683
Titre abrégé: Cardiol Rev
Pays: United States
ID NLM: 9304686
Informations de publication
Date de publication:
30 Jul 2024
30 Jul 2024
Historique:
medline:
30
7
2024
pubmed:
30
7
2024
entrez:
30
7
2024
Statut:
aheadofprint
Résumé
Heart transplant (HT) recipients are more frequently reaching childbearing age given improvement in median survival and outcomes after HT. Although most pregnancies in HT recipients have favorable outcomes, poor fetal outcomes and maternal complications such as hypertensive disorders of pregnancy are more common in HT recipients than in the general population. In this review, we summarize the current evidence to guide the management of pregnancy in HT recipients. Preconception counseling, focused on risk stratification and optimal timing of conception, is the first important step to optimize pregnancy outcomes. During pregnancy and in the postpartum period, frequent monitoring of graft function and immunosuppressive levels is recommended. Calcineurin inhibitors and corticosteroids should be the mainstay of treatment for both prevention and treatment of graft rejection. Delivery planning should follow usual obstetric indications, preferably with vaginal delivery at term using regional anesthesia. A multidisciplinary care team should be involved in management through all stages of pregnancy to ensure success.
Identifiants
pubmed: 39078143
doi: 10.1097/CRD.0000000000000758
pii: 00045415-990000000-00305
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: R.C.: CVRx honorarium for educational presentations. The other authors declare no conflict of interest.
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