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Gynaecology & Obstetrics Cardiovascular Disorders 38246451

Normal pregnancy can be continued in -

A
Primary pulmonary hypertension
B
Wolf-Parkinson-White syndrome
C
Eisenmenger syndrome
D
Marfan syndrome with dilated aortic root
High-Yield Explanation
Ans. is 'b' i.e., Wolf Parkinson-While syndrome Marfan's syndromeIdeally, a patient with Marfan's syndrome contemplating pregnancy should have a preconceptional echocardiography to determine the diameter of the aortic root risk depends upon the diameter of aortic root. If it is greater than 4.0 cm, she is at significant risk for aortic dissection and she should be offered surgery. If the patient is in early pregnancy, she should be informed that termination of pregnancy is an option.Eisenmenger syndrome & pulmonary hypertensionPulmonary vascular disease whether secondary to a reversed large left to right shunt such as VSD, Eisenmenger's syndrome or lung or connective tissue disease (e.g., scleroderma) or due to primary pulmonary hypertension is extremely dangerous in pregnancy and women blown to have significant pulmonary vascular disease should be advised from an early age to avoid pregnancy and be given appropriate contraceptive advice.Arias says (<Pregnancy is deleterious to patients with primary pulmonary hypertension. The maternal mortality is approximately 40% and the fetal outcome is also poor with frequent spontaneous abortions and fetal demises secondary to maternal deaths. "According to Dutta,Absolute indications for termination of pregnancy are:-Primary pulmonary hypertensionEisenmenger's syndromePulmonary veno-occlusive diseaseRelative indications areParous woman with grade III and grade IV cardiac lesions.Grade I or II with previous history of cardiac failure in early month or in between pregnancy.The termination should be done within 12 weeks by suction evacuation (MVA) or by conventional D & E.

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