RESUMO
O avanço no tratamento das cardiopatias tem permitido um progressivo número de mulheres com doenças cardíacas congênitas alcançarem a idade reprodutiva e a gravidez. Assim, o conhecimento sobre as modificações fisiológicas do ciclo gravídico-puerperal e sua interface com as lesões cardiacas estruturais é fundamental para a adequada conduta em portadoras de cardiopatia congênita durante a gestação. Neste artigo, discutiremos os fatores de prognóstico materno-fetal, as principais complicações, os cuidados obstétricos durante a gestação, parto e puerpério e o planejamento familiar da mulher com cardiopatia congênita.
Advances in the treatment of congenital heart defects has led to a gradually increase in the number of women with congenital heart defects reaching reproductive age and pregnancy. Thus, a knowledge of the physiological changes of the pregnant-puerperal cycle, and their interface with structural heart defects, is essential for adequate conduct in patients with congenital heart disease during pregnancy. In this article, we discusses thefactors of maternal-fetal prognosis, the main complications, the obstetric care provided during pregnancy, labor and puerperium, and family planning for women with congenital heart defects.
Assuntos
Humanos , Feminino , Adulto , Cardiopatias Congênitas/mortalidade , Cardiopatias Congênitas/terapia , Cuidado Pré-Natal/métodos , Fatores de Risco , Gravidez , Parto , Desenvolvimento Fetal , Hereditariedade , Hipertensão Pulmonar Primária Familiar , Mortalidade Materna , Mulheres , Técnica de Fontan/métodosRESUMO
Sepsis is one of the main causes of maternal death, being related to infections from obstetric origin (infected abortion, chorioamnionitis, puerperal infection) or non-obstetric (resulting from infections which occur in other areas). This review aims at describing the mechanisms involved in the physiopathology of this entity and at updating the clinical approach to sepsis, recommended in international guidelines (early goal-directed therapy--precocious resuscitation, or precocious treatment guided by goals), as well as at calling attention to the influence of pregnancy both in the clinical manifestation and in the therapeutic management of septic conditions.
