RESUMO
This review on early pregnancy complications and obesity will focus on the known pregnancy complications such as miscarriage (whether spontaneous or after fertility treatment), polycystic ovaries and risk of miscarriage, recurrent pregnancy loss, ectopic pregnancy, hyperemesis gravidarum and birth defects. Evidence will be assessed and mechanistic pathways for the outcomes will be described. We know that obesity is now a pandemic and has an impact on early pregnancy complications. The evidence has been summarised to provide the reader with a comprehensive overview and advice for pregnant women with obesity in early pregnancy.
Assuntos
Aborto Habitual , Aborto Espontâneo , Infertilidade Feminina , Síndrome do Ovário Policístico , Complicações na Gravidez , Gravidez , Feminino , Humanos , Infertilidade Feminina/etiologia , Indução da Ovulação/efeitos adversos , Aborto Habitual/etiologia , Aborto Habitual/prevenção & controle , Taxa de Gravidez , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/terapia , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/terapia , Complicações na Gravidez/etiologia , Complicações na Gravidez/terapiaRESUMO
Assisted conception involving hormonals is a risk factor for spontaneous coronary artery dissection (SCAD), and pregnant women with spontaneous coronary artery dissection are more likely to have had treatment for subfertility. Increasingly, there is a risk of maternal death in women after assisted conception, and so, the need to assess the cardiovascular sequelae after assisted conception is imperative. This is an illustrative case of spontaneous coronary artery dissection shortly after a repeat cycle of in vitro fertilisation (IVF). The aetiology of spontaneous coronary artery dissection is believed to be multi-factorial, affecting mostly young women, a population similar to women requiring assisted conception. The oestrogen and progesterone used in in vitro fertilisation are believed to trigger structural weakening in the coronary blood vessels, leading to vascular rupture. Repeat in vitro fertilisation cycles and successful conception are thought to increase spontaneous coronary artery dissection risk by increasing hormonal exposure. The management of spontaneous coronary artery dissection is dependent on if pregnancy has been achieved or not, and a multi-disciplinary approach to its management is essential. More research is needed to identify women at higher risk of this life-threatening event.
