The Inter-American Society of Cardiology produces a book on heart diseases in pregnant women. What are the changes and symptoms to be aware of?
What are the cardiovascular changes and adjustments in pregnancy? Are chest pain and shortness of breath common in pregnant women? Should pregnant women undergoing treatment change medications to avoid affecting the fetus? Here are some key questions about The health of pregnant people will be answered in a book by the Inter-American Society of Cardiology (SIAC) to be published in the middle of this year,
Research on women’s health, until recently, was preferentially oriented to fertility and reproduction. The reference to serious chronic diseases, such as heart disease, was based on studies on male populations.
SIAC recognized this outstanding debt of women and is currently leading the way in contributions on prevention, diagnosis and treatment. In fact, last June it published the first Latin American guide to preventing heart disease in women.
In this context, the members of SIAC are faced with the preparation of a book on cardiovascular diseases in pregnant women. Co-publishing the book, which aims to be ready by the middle of this year, is in charge of three Latin American doctors: Colombian Ana Munera, director of the SIAC Community Council; Dominican Claudia Almonte, director of the SIAC Women’s Council, and Argentine Mildran del Sueldo, director of Women in Red of the Argentine Federation of Cardiology.
“It’s always good to update this issue as there is new evidence about the management of cardiovascular problems during pregnancy and not only during pregnancy but what they leave behind in the future life of that mother and that child,” she told Telem. Said in an interview with – Trust, Mildren del Sueldo, A benchmark for cardiovascular prevention in women.
,There are certain complications during pregnancy that occur in healthy or possibly healthy women, such as high blood pressure during pregnancy, gestational diabetes, preterm delivery, all of which carry an increased risk throughout the future life of that mother and child. She leaves. heart rate For life,” del Sueldo explained.
Along these lines, he highlighted a concept he handles in the specialty: fourth quarter risk. “It is not that there is another trimester in pregnancy, but the fourth trimester refers to the rest of the life of the mother who must continue to take care of herself and enter a cardiovascular risk control program from the moment she has the baby. About us are working on it and raising awareness in both the general public and the medical community,” he said.
And he continued: “As we work in primary care and prevention of heart disease it is important to keep this in mind when evaluating a woman who has any of these complications during pregnancy.”
Del Sueldo is a native of Córdoba, author of numerous research papers and scientific publications. She works as Coordinator of the Cardiology and Prevention Service of the Specialty Clinic and Certificate, Health, Training and Rehabilitation Center, Villa María, Córdoba. He also takes advantage of his teaching aspect in a Master’s degree in Diabetes at the National University of Córdoba and in a Diploma in Arterial Hypertension at the University of Favaloro.
“Much can be done to prevent, for example, Planning pregnancy, antenatal check-up, that the mother’s blood pressure is controlled, that she is of sufficient weight, that she does not smoke, that she is physically active, All these issues coupled with healthy lifestyle habits reduce the chances of getting this type of complication during pregnancy. For this reason, we talk about three stages before, during and after pregnancy with emphasis on: good preparation of the woman who wishes to become pregnant; good control of pregnancy; And then in those women who have had some complications, they should be under observation. And here the obstetrician plays an important role because he has to warn the mother that she should continue with postnatal follow-up.”
“Usually, both high blood pressure in pregnancy and gestational diabetes disappear after the baby is born, but the problem does not end there. It should be noted that check-ups are done at three months, six months, one year and Should be done less later. Once a year,” said the cardiologist.
And he added: “Although they are typical signs for those who presented some complications in pregnancy but today, We declare that early prevention that has no age to start it, Our advice is to have a heart check-up every year or every two years; more so if the parents have a history of arterial hypertension or high cholesterol”.
When asked about the frequency with which possibly healthy women are seen in the doctor’s office with some cardiovascular disorder, he replied that “it’s not that sporadic, about 2 to 10% of pregnancies have these kinds of complications.” may present, born with low birth weight, high blood pressure, gestational diabetes or pre-term delivery”.
“Now – he said – during pregnancy there are many complex and dynamic physiological changes that take place in the pregnant woman’s body during the growth and development of the baby which will reach their maximum near the end of pregnancy and gradually disappear afterwards. Healthy women can easily adapt to these changes, whereas women who have underlying heart conditions, congenital heart disease, valve problems, cardiomyopathy may not adapt easily and pregnancy These symptoms may begin with dyspnea (shortness of breath), tachycardia (feeling like a very fast heartbeat), chest pain or edema (swelling of the legs). However, it is necessary to consult quickly, “the expert developed.
he also outlined “Some complications in pregnancy, believed to be of low incidence in healthy women, are peripartum cardiomyopathy which usually occurs in the late stages of pregnancy or the first stage of the puerperium.or, that it could cause heart failure in the woman and leave her with a sequela for the rest of her life”.
“Heart attacks are not common in pregnant women but can occur, there is an entity called spontaneous coronary artery dissection (tear inside the artery that carries blood to the heart) which is the most frequent cause of heart attacks in pregnant women and they are puts her life and the baby’s life at risk, so you have to be very careful,” he concluded conclusively: “A woman with heart disease will always have a high-risk pregnancy.”
With respect to women with cardiovascular disease prior to pregnancy, the treating team should modify drug treatment to prevent harm to the fetus.
“When a woman with heart disease becomes pregnant, there are drugs that must be changed because they are contraindicated. There are drugs that have teratogenic effects that can affect the development of the baby and should be avoided,” Dr. “For all of us who manage high-risk pregnancies, we know which drugs can be used that have a low risk of embryologic (harm to the baby),” she said.
Finally, regarding the effect of agrochemicals on the presence of congenital heart disease, he said: “Other studies at the experimental level and at the observational level show a higher incidence of heart disease in some areas of the country where agrochemicals are used.” Birth defects as well as malformations have been observed, for example in children born to mothers living in those areas”.