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. 2022 Jan 17;58(1):138. doi: 10.3390/medicina58010138
Questions
PHARMACOTHERAPY
1 Every woman with idiopathic pulmonary hypertension in reproductive age, regardless of the severity of the disease, should use an effective method of contraception.
2 The use of almost all β-blockers in pregnancy may be associated with a risk of intrauterine fetal development delay.
3 Pregnant women with antiphospholipid syndrome (APS) are recommended to restart treatment with vitamin K antagonists from the second trimester of pregnancy.
4 Routine antibiotic prophylaxis should be implemented in pregnant women with the diagnosed valvular disease who are at risk of infective endocarditis.
5 Within pregnant women with severe arterial hypertension, hydralazine should be used only when other pharmacological treatments are ineffective.
6 Inhalation anesthetics should be avoided in pregnant women undergoing non-obstetric surgeries during pregnancy.
DELIVERY AND POSTPARTUM
1 If it is clinically indicated, planned coronary angioplasty should be performed in pregnant women after the delivery
2 Vaginal delivery with epidural anesthesia should be the first choice method for women with symptoms of aortic stenosis.
3 Every pregnant woman with symptomatic pulmonary hypertension should have a Swan–Ganz catheter inserted for labor.
4 Women with heart failure and a reduced ejection fraction, regardless of the puerperal clinical condition, should be discouraged from breastfeeding.
STATES OF INSTANT DANGER TO LIFE
1 Within pregnant women with pulmonary embolism, thrombolytic therapy should be used only in the event of cardiogenic shock.
2 Every pregnant woman with the symptomatic valvular disease should be hospitalized in the intensive care unit, even after an uncomplicated delivery.
3 Each type of anesthesia increases the likelihood of developing aortocaval compression syndrome.
PROCEDURES
1 Within women with symptoms of circulatory failure and idiopathic pulmonary hypertension, pregnancy should be terminated at its earliest stage.
2 A pregnant woman with diagnosed idiopathic pulmonary hypertension should undergo catheterization of the right heart in the first trimester of pregnancy.
3 Cesarean section should be the first-choice method for a pregnant woman with idiopathic pulmonary hypertension.
4 NT-proBNP levels should be measured routinely in all pregnant women with symptoms of heart failure in each trimester of pregnancy.
5 Within women being in reproductive age with severe aortic stenosis, percutaneous balloon valvuloplasty should be performed preventively before a planned pregnancy.
6 Electrical cardioversion is a safe procedure for the mother and the fetus in each trimester of pregnancy