Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Charlotte Patient
Document related concepts
Transcript
Obstetric management of cardiac patients Charlotte Patient Charleen Lia Is the Baby moving well? The role of the obstetrician • • • • • Pre-pregnancy Care Co-ordinate the MDT Worry about the baby Plan the delivery Avoid unplanned pregnancies Pre-pregnancy • Advise on risk • Advise on medications • Consider other investigations/referrals • Make a plan for the pregnancy MDT • • • • • • • • • • • Obstetrician Cardiologist Anaesthetist Midwife Haematologist Neonatologist Intensivist Cardiothoracic Clinical Pharmacology Rheumatology Genetics The baby • All babies have fetal echo as part of the national anomaly screening programme • Detect about 50% of CHD • Additional screening offered to mothers at higher risk • CHD may also occur as a result of chromosomal or genetic abnormalities • Background risk of fetal heart abnormality 8-9/1000 (0.8%) • Mother has congenital heart disease 5-50% Fetal growth • May be affected by disease? • May be affected by drugs? • Tend to offer additional growth scans Delivery Place Timing Mode Mode of delivery Cardiac disease does not usually equal delivery by Caesarean Section Cardiac disease does not usually equal delivery in a Midwifery Led Unit Timing • Ideally wait for spontaneous labour • May not work because – Need to manage other medications – May be evidence of deterioration – Geography The short second stage? Post natal • Breastfeeding • Contraception LARC
