Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening?
BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7356.157 (Published 20 July 2002) Cite this as: BMJ 2002;325:157
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this is an intriguing cardiac condition, uncommon, but occurs in
primipara of about 30yrs, with twin pregnancies,and possibly poor
nutritional status. it presents with heart failure in the last month of
pregnancy up to 5months after delivery.the cause is not known. it occurs
in pregnant women without previous heart disease.to date no known cause
been described. theories abound about toxic, metabolic, viral or
inflammatory agent. as fetus is a common factor an auto-immune phenomena
is described. the occurrence of this disease in young women and clustering
in the peripartum period suggest this disease to be a distinct entity from
ordinary idiopathic dilated cardiomyopathy.the patient become symptomatic
after the burden of hemodynamic changes are resolving in contrast to
ischaemic, hypertensive, vulvular, or vascular conditions. patient may
become symptomatic well after delivery. more and more cases of heart
failure in pregnancy in our set-up are diagnosed to have peri-partum
cardiomyopathy on echocardiography.diagnosis is based on development of
heart failure in the last trimester or post delivery, absence of
identifiable cause and demonstration of significant systolic dysfunction
of lv. spontaneous recovery occur in a large proportion of patients. it
may take up to six months from date of diagnosis.as complete recovery is
known to occur, it is tempting to allow patient subsequent pregnancies.
however, using dobutamine stress test, significant residual contractile
dysfunction has been reported, thus patient should be discouraged a future
pregnancy.recurrence in subsequent pregnancy may be fatal.
Competing interests:
None declared
Competing interests: No competing interests
Association of Teenage Pregnancy with Acute Coronary Syndrome
Associaton of Teenage Pregnancy with Acute Coronary syndrome
Manzar Hossein akbar;
Heshmat Cardiovascular research center Rasht,
Guilan University of Medical Sciences, Iran
Background: Females are biologicaly different, so is the process of
coronary disease (CAD) in women. Teenage pregnancy is common in third
world society.
We studied the relation of age at first pregnancy to the major modifiable
CAD risk factors and out come of Acute Coronary syndrome in rural women
aged
40-59 years.
Method: This is a hospital based descriptive prospective cross
sectional study using self reported age at first pregnancy of 120 rural
women admitted for the first time with the confirmed diagnosis of Acute
Coronary syndrome. Age on admission, demography, documentations of major
major modifiable CAD risk factors and out come of Acute Coronary syndrome
were extractedfrom hospital case record and analyzed by standard research
methodology. Chi 2 test was used for comparison.
Results: The mean age at first pregnancy of 120 CAD patients was 19.2
years
(Range 14-29 years. Mode= 18-20 years). Most of the patients were aged 49
years or younger, 64 (58 %) patients reported their age as 19 or younger
at the time of first pregnancy (Study Group). While 56 (42 %) were
within the age group of 20-29 years on first pregnancy (Control group).
(69 %) patients of teenage pregnancy were suffering from metabolic
syndrome in comparison of (31 %) in control group having three major
modifiable CAD risk factors or more.
Conclusion: This study revealed the
significant association of Metabolic Syndrome and developement of
premature Acute Coronary syndrome in women with teenage pregnancy.
Competing interests:
Age at First Pregnancy (teenage)is also linked to Metabolic Syndrome
Competing interests: No competing interests