to describe changes in characteristics of delivery and postpartum hospitalisations with chronic heart disease from 1995 to 2006.
USA, nationwide hospital discharge data.
a total of 47 882 817 delivery hospitalisations and 660 038 postpartum hospitalisations.
adjusted odds ratios describing the associations between chronic maternal heart disease and severe obstetric complications were obtained from multivariable logistic models. The contribution of chronic heart disease to severe morbidity was estimated using adjusted population-attributable fractions.
prevalence and trends in chronic heart disease, rate and risk of severe obstetric complications.
in 2004-2006, about 1.4% of delivery hospitalisations were complicated with chronic heart disease. No substantial changes in the overall prevalence of chronic heart disease among hospitalisations for delivery were observed from 1995-1997 to 2004-2006. Even so, a linear increase was found for specific congenital heart disease, cardiac dysrhythmias, and cardiomyopathy and congestive heart failure (P < 0.01). During this same period the rate of postpartum hospitalisations with chronic heart disease tripled (P < 0.01). Severe complications during hospitalisations for delivery among women with chronic heart disease were more common in 2004-2006 than in 1995-1997. In 2004-2006, 64.5% of the cases of acute myocardial infarction, 57.5% of the instances of cardiac arrest/ventricular fibrillation, 27.8% of in-hospital mortality and 26.0% of the cases of adult respiratory distress syndrome were associated with hospitalisations with chronic heart disease.
in the USA chronic heart disease among women hospitalised during pregnancy may have increased in severity from 1995 to 2006.
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"Lastly, they found that other cardiomyopathies were more common than peripartum cardiomyopathy during pregnancyrelated hospitalizations . In another study from the years 1995 to 2006 by the same group, the investigators found a linear increase in the prevalence of both congenital heart disease and cardiomyopathy complicating pregnancy . The ICD-9 code, 674.5 for peripartum cardiomyopathy, was first introduced in 2003. "
"Cardiac disease complicates more than 1% of pregnancies in the US and causes 20% of non-obstetrical deaths [1,2]. The increase of heart disease in pregnancy is attributed to increased rates of obesity, hypertension and diabetes, in addition to the survival of women with congenital heart disease to maternal age. "
"disease is the most common cause of maternal mortality  . The incidence of myocardial infarc- tion  and complicated cardiac disease during pregnancy is on the rise based on data from the United States  . Fibrinolysis is relatively contraindicated in pregnancy, and, therefore, primary percutaneous coronary intervention is the reperfusion strategy of choice to treat ST segment elevation myocardial infarction in the pregnant woman  . "
[Show abstract][Hide abstract]ABSTRACT: Cardiac arrest during pregnancy is a dedicated chapter in the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care; however, a robust maternal cardiac arrest knowledge translation strategy and emergency response plan is not usually the focus of institutional emergency preparedness programs. Although maternal cardiac arrest is rare, the emergency department is a high-risk area for receiving pregnant women in either prearrest or full cardiac arrest. It is imperative that institutions review and update emergency response plans for a maternal arrest. This review highlights the most recent science, guidelines, and recommended implementation strategies related to a maternal arrest. The aim of this paper is to increase the understanding of the important physiological differences of, and management strategies for, a maternal cardiac arrest, as well as provide institutions with the most up-to-date literature on which they can build emergency preparedness programs for a maternal arrest.