Pathologies cardiaques chez la femme enceinte

Pregnancy induces an increase in blood volume and cardiac output that may impair the evolution of a preexisting cardiac disease that may itself compromise the outcome of pregnancy. Congenital cardiac diseases are nowadays the most frequent in Western Europe, the most risky are those with pulmonary hypertension and/or right to left shunting. Valvular heart diseases are less frequent but mitral stenosis is prone to lead to pulmonary edema indicative of percutaneous valvuloplasty. Thromboembolic risk is increased during pregnancy, heparin administration must be substituted to vitamin K antagonists that may induce foetal abnormalities. Peripartum cardiomyopathy may recover within a few months but contraindicates any further pregnancy. Marfan syndrome conveys a risk of aortic dissection during labour, indicative of delivery by C-section.