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J Am Coll Cardiol. 2019 Feb 5;73(4):457-476. doi: 10.1016/j.jacc.2018.10.075.

Use of Medication for Cardiovascular Disease During Pregnancy: JACC State-of-the-Art Review.

Author information

1
Adult Congenital Heart Disease Program, Cardiology Division, NYU Langone Health, New York, New York. Electronic address: dan.halpern@nyumc.org.
2
Adult Congenital Heart Disease Program, Cardiology Division, NYU Langone Health, New York, New York.
3
Division of Maternal Fetal Medicine, Department of Obstetrics & Gynecology, New York University Langone Health, New York, New York.
4
Pregnancy and Cardiovascular Disease Program, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
5
Boston Adult Congenital Heart Disease Program, Boston Children's Hospital and Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Abstract

Cardiovascular disease complicating pregnancy is rising in prevalence secondary to advanced maternal age, cardiovascular risk factors, and the successful management of congenital heart disease conditions. The physiological changes of pregnancy may alter drug properties affecting both mother and fetus. Familiarity with both physiological and pharmacological attributes is key for the successful management of pregnant women with cardiac disease. This review summarizes the published data, available guidelines, and recommendations for use of cardiovascular medications during pregnancy. Care of the pregnant woman with cardiovascular disease requires a multidisciplinary team approach with members from cardiology, maternal fetal medicine, anesthesia, and nursing.

KEYWORDS:

cardiovascular medications; gestation; pharmacokinetics; pregnancy

PMID:
30704579
DOI:
10.1016/j.jacc.2018.10.075

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