Cardiopatias e gravidez / Heart diseases and pregnancy

RESUMO

As cardiopatias complicam de 0,2 a 4,0% as gestações nos países ocidentais. Apesar de o resultado materno-fetal ser favorável na maioria dos casos, pacientes cardiopatas devem receber aconselhamento pré-concepcional adequado. Nessas pacientes, há risco aumentado para insuficiência cardíaca congestiva e arritmias cardíacas durante a gravidez, o parto e o puerpério. As cardiopatias congênitas e reumáticas são as principais etiologias nesses casos. O pré-natal deve ser realizado em serviços terciários com equipes multidisciplinares, familiarizadas com gestação de alto risco. Neste artigo, revisou-se a literatura sobre cardiopatias na gravidez, enfatizando o aconselhamento pré-concepcional e o manejo pré-natal.

ABSTRACT

Heart diseases complicate from 0.2 to 4.0% of all pregnancies in Western countries. Although the maternal-fetal outcome obtained in most cases is favorable, patients should receive adequate preconcepcional counseling. In these patients, there is an increased risk for congestive heart failure and cardiac arrhythmias during pregnancy, delivery, and puerperium. Congenital and rheumatic heart diseases are the main conditions involved in these cases. The prenatal care must take place in tertiary services with multidisciplinary staff, well-trained in high-risk pregnancies. In this paper, we have reviewed the literature on heart diseases in pregnancy, emphasizing the preconcepcional counseling and prenatal management.