Table 7.

Delivery management in pregnant women with IHD

Such conditions as iron deficiency anemia and volume depletion may exacerbate underlying ischemia.

Hypotension should be avoided to limit demand ischemia as well as placental hypoperfusion.

Hypertensive episodes, particularly in the setting of gestational hypertension or pre-eclampsia, should be aggressively treated in pregnant women with IHD to avoid exacerbation of ischemia and increase in afterload.

In regard to mode of delivery, in general, there are no data to suggest that cesarean section is associated with improved outcomes over vaginal delivery in women with IHD.

Overall, vaginal delivery is encouraged whenever possible to avoid infectious risk and excess bleeding with consideration for assisted second stage and efforts to minimize blood loss and reduce tachycardia.

IHD – Ischemic Heart Disease