2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy
Table of Contents
Abbreviations and acronyms
1. Preamble
2. Introduction
2.1 Why do we need new Guidelines on the management of cardiovascular diseases in pregnancy?
2.2 New format of the Guidelines
2.3 Why these Guidelines are important
2.4 Methods
2.5 What is new?
3.General considerations
3.1 Epidemiology
3.2 Physiological adaptations to pregnancy
3.3 Pre-pregnancy counselling
3.4 Cardiovascular diagnosis in pregnancy
3.5 Genetic testing and counselling
3.6 Foetal assessment
3.7 Interventions in the mother during pregnancy
3.8 Timing and mode of delivery: risk for mother and child
3.9 Infective endocarditis
3.10 Methods of contraception and termination of pregnancy, and in vitro fertilization
3.11 RecommendationsCongenital heart disease and pulmonary hypertension
4. Congenital heart disease and pulmonary hypertension
4.1 Introduction
4.2 Pulmonary hypertension and Eisenmenger’s syndrome
4.3 Specific congenital heart defects
4.4 Recommendations
5. Aortic diseases
5.1 Maternal and offspring risk.
5.2 Specific syndromes.
5.3 Management
5.4 Recommendations
6.Valvular heart disease
6.1 Stenotic valve lesions
6.2 Regurgitant lesions
6.3 Atrial fibrillation in native heart valve disease
6.4 Prosthetic valves
6.5 Mechanical prostheses and anticoagulation
6.6 Recommendations
7. Coronary artery disease
7.1 Aetiology
7.2 Presentation and diagnosis
7.3 Management
7.4 Pharmacotherapy
7.5 Intervention
7.6 Pre-existing CAD
7.7 Labour and delivery
7.8 Recommendations
8. Cardiomyopathies and heart failure.
8.1 Peripartum cardiomyopathy
8.2 Dilated cardiomyopathy.
8.3 Management of heart failure during and after pregnancy
8.4 Hypertrophic cardiomyopathy
8.5 Recommendations
9. Arrhythmias
9.1 Introduction
9.2 Maternal risk
9.3 Obstetric and offspring risk
9.4 Supraventricular tachycardia
9.5 Atrial fibrillation and atrial flutter
9.6 Ventricular tachycardia
9.7 Bradyarrhythmias
9.8 Interventions.
9.9 Recommendations
10.Hypertensive disorders
10.1 Diagnosis and risk assessment
10.2 Definition and classification of hypertension in pregnancy
10.3 Prevention of hypertension and pre-eclampsia
10.4 Management of hypertension in pregnancy
10.5 Delivery
10.6 Prognosis after pregnancy
10.7 Recommendations.
11. Venous thrombo-embolic disease during pregnancy and the puerperium
11.1 Epidemiology and maternal risk
11.2 Risk factors for pregnancy-related venous thrombo-embolism and risk stratification
11.3 Prevention of venous thrombo-embolism.
11.4 Management of acute venous thrombo-embolism
11.4.1 Pulmonary embolism.
11.5 Recommendations
12. Drugs during pregnancy and breastfeeding
12.1 General principles
12.2 US Food and Drug Administration classification
12.3 Internet databases
12.4 Pharmaceutical industry
12.5 Recommendations
13.Gaps in the evidence
14. Key messages
15. ‘What to do’ and ‘what not to do’ messages from the Guidelines
16. Appendix
Supplementary material
References