Kardiologische Erkrankungen in der Schwangerschaft

Serious cardiac disease has a significant impact on maternal and fetal morbidity and mortality. The overall incidence is estimated at approximately 1%. In Germany, about 6000 pregnancies in women with congenital or acquired valvular lesions are expected per year. The etiology of the disease has changed during the past several years from predominantly rheumatic disease to an equal incidence of rheumatic and congenital heart disease. Normal physiologic changes during pregnancy and delivery can aggravate underlying cardiac disease and lead to the associated mortality and morbidity. Cardiovascular alterations during pregnancy are characterized by an increased vascular volume, cardiac output, and heart rate, with a fall in peripheral vascular resistance. The peripartal phase represents another critical period. Treatment and outcome will depend on the type of cardiac disease, on the functional impairment of the fetal heart and on the status of the fetus. Close interdisciplinary collaboration and tightly networked support are the prerequisite for successful management of high-risk pregnancies involving maternal heart disease.