TY  - BOOK
AU  - Gupta, Richa
AU  - Hussien, Merna
AU  - Lam, Phillip H
AU  - Lorente-Ros, Marta
TI  - Preparing the Heart for a New Baby: Management of Pregnancy in Heart Transplant Recipients
SN  - 1061-5377
PY  - 2024///
KW  - Automated
KW  - IN PROCESS -- NOT YET INDEXED
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Cardiovascular Disease Fellowship
KW  - Journal Article
N1  - Available online from MWHC library: 2001 - present
N2  - 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
UR  - https://dx.doi.org/10.1097/CRD.0000000000000758
ER  -