Preparing the Heart for a New Baby: Management of Pregnancy in Heart Transplant Recipients.
Preparing the Heart for a New Baby: Management of Pregnancy in Heart Transplant Recipients.
- 2024
Available online from MWHC library: 2001 - present
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. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
English
1061-5377
00045415-990000000-00305 [pii]
--Automated
IN PROCESS -- NOT YET INDEXED
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Cardiovascular Disease Fellowship
Journal Article
Available online from MWHC library: 2001 - present
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. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
English
1061-5377
00045415-990000000-00305 [pii]
--Automated
IN PROCESS -- NOT YET INDEXED
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Cardiovascular Disease Fellowship
Journal Article