<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">To review a case series of 12 women with unexpected h...<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">To review a case series of 12 women with unexpected heart and lung disorders that occurred during pregnancy and the puerperium, describing for teaching purposes the pitfalls in practice and the lessons learned from this experience. </span><b><span style="font-family:Verdana;">Materials & Methods: </span></b><span style="font-family:Verdana;">We reviewed case files of women with medical and/or hypertensive complications of pregnancy that were evaluated </span><span style="font-family:Verdana;">for medicolegal defense purposes by the first author between 1986-2015.</span> <span style="font-family:Verdana;">Twelve women in these case files experienced unexpected cardiovascular</span><span style="font-family:Verdana;"> and/or cardiopulmonary complications late in pregnancy or early in the puerperium. For each case, the pertinent medical record information was extracted. Im</span><span style="font-family:Verdana;">portant concepts as lessons learned are summarized and referenced for</span><span style="font-family:Verdana;"> teaching purposes. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Five women had undetected preexisting heart disease which acutely deteriorated during the third trimester, four women developed postpartum heart failure related to pregnancy and delivery, and three women </span><span style="font-family:Verdana;">suffered an intrapartum cardiac arrest;none survived. Their case presenta</span><span style="font-family:Verdana;">tions illustrate the importance of obstetric health care professionals being alert to the signs/symptoms of developing cardiopulmonary disease late in pregnancy and following delivery so that timely evaluation and intervention can be accomplished to potentially avoid morbidity and mortality. Diagnostic categories include peripartum heart failure, high-risk chronic hypertension, superimposed preeclampsia, amniotic fluid embolism, pulmonary embolism and Raynaud’s with occult pulmonary hypertension. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">These cases illustrate the diversity of ways that cardiovascular disease can suddenly complicate pregnancy and the early postpartum period. A major part of any effort to enhance safer motherhood is a heightened awareness by obstetric specialists to consider the possibility of heart disease in all maternity patients so that appropriate consultation and collaboration with other specialists might help avoid major maternal morbidity or mortality.</span></span></span></span>展开更多
文摘<strong>Objective: </strong><span><span><span style="font-family:""><span style="font-family:Verdana;">To review a case series of 12 women with unexpected heart and lung disorders that occurred during pregnancy and the puerperium, describing for teaching purposes the pitfalls in practice and the lessons learned from this experience. </span><b><span style="font-family:Verdana;">Materials & Methods: </span></b><span style="font-family:Verdana;">We reviewed case files of women with medical and/or hypertensive complications of pregnancy that were evaluated </span><span style="font-family:Verdana;">for medicolegal defense purposes by the first author between 1986-2015.</span> <span style="font-family:Verdana;">Twelve women in these case files experienced unexpected cardiovascular</span><span style="font-family:Verdana;"> and/or cardiopulmonary complications late in pregnancy or early in the puerperium. For each case, the pertinent medical record information was extracted. Im</span><span style="font-family:Verdana;">portant concepts as lessons learned are summarized and referenced for</span><span style="font-family:Verdana;"> teaching purposes. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Five women had undetected preexisting heart disease which acutely deteriorated during the third trimester, four women developed postpartum heart failure related to pregnancy and delivery, and three women </span><span style="font-family:Verdana;">suffered an intrapartum cardiac arrest;none survived. Their case presenta</span><span style="font-family:Verdana;">tions illustrate the importance of obstetric health care professionals being alert to the signs/symptoms of developing cardiopulmonary disease late in pregnancy and following delivery so that timely evaluation and intervention can be accomplished to potentially avoid morbidity and mortality. Diagnostic categories include peripartum heart failure, high-risk chronic hypertension, superimposed preeclampsia, amniotic fluid embolism, pulmonary embolism and Raynaud’s with occult pulmonary hypertension. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">These cases illustrate the diversity of ways that cardiovascular disease can suddenly complicate pregnancy and the early postpartum period. A major part of any effort to enhance safer motherhood is a heightened awareness by obstetric specialists to consider the possibility of heart disease in all maternity patients so that appropriate consultation and collaboration with other specialists might help avoid major maternal morbidity or mortality.</span></span></span></span>
