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Bianca I, Geraci G, Gulizia MM, et al. Consensus Document of the Italian Association of Hospital Cardiologists (ANMCO), Italian Society of Pediatric Cardiology (SICP), and Italian Society of Gynaecologists and Obstetrics (SIGO): pregnancy and congenital heart diseases. Eur Heart J Suppl. 2017;19:D256-D292doi: 10.1093/eurheartj/sux032.
Bianca, I., Geraci, G., Gulizia, M. M., Egidy Assenza, G., Barone, C., Campisi, M., Alaimo, A., Adorisio, R., Comoglio, F., Favilli, S., Agnoletti, G., Carmina, M. G., Chessa, M., Sarubbi, B., Mongiovì, M., Russo, M. G., Bianca, S., Canzone, G., Bonvicini, M., Viora, E., & Poli, M. (2017). Consensus Document of the Italian Association of Hospital Cardiologists (ANMCO), Italian Society of Pediatric Cardiology (SICP), and Italian Society of Gynaecologists and Obstetrics (SIGO): pregnancy and congenital heart diseases. European heart journal supplements : journal of the European Society of Cardiology, 19D256-D292. https://doi.org/10.1093/eurheartj/sux032
Bianca, Innocenzo, et al. "Consensus Document of the Italian Association of Hospital Cardiologists (ANMCO), Italian Society of Pediatric Cardiology (SICP), and Italian Society of Gynaecologists and Obstetrics (SIGO): pregnancy and congenital heart diseases." European heart journal supplements : journal of the European Society of Cardiology vol. 19 (2017): D256-D292. doi: https://doi.org/10.1093/eurheartj/sux032
Bianca I, Geraci G, Gulizia MM, Egidy Assenza G, Barone C, Campisi M, Alaimo A, Adorisio R, Comoglio F, Favilli S, Agnoletti G, Carmina MG, Chessa M, Sarubbi B, Mongiovì M, Russo MG, Bianca S, Canzone G, Bonvicini M, Viora E, Poli M. Consensus Document of the Italian Association of Hospital Cardiologists (ANMCO), Italian Society of Pediatric Cardiology (SICP), and Italian Society of Gynaecologists and Obstetrics (SIGO): pregnancy and congenital heart diseases. Eur Heart J Suppl. 2017 May;19:D256-D292. doi: 10.1093/eurheartj/sux032. Epub 2017 May 02. PMID: 28751846; PMCID: PMC5526477.
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Eur Heart J Suppl. 2017 May;19:D256-D292. doi: 10.1093/eurheartj/sux032. Epub 2017 May 02.

Consensus Document of the Italian Association of Hospital Cardiologists (ANMCO), Italian Society of Pediatric Cardiology (SICP), and Italian Society of Gynaecologists and Obstetrics (SIGO): pregnancy and congenital heart diseases.

European heart journal supplements : journal of the European Society of Cardiology

Innocenzo Bianca, Giovanna Geraci, Michele Massimo Gulizia, Gabriele Egidy Assenza, Chiara Barone, Marcello Campisi, Annalisa Alaimo, Rachele Adorisio, Francesca Comoglio, Silvia Favilli, Gabriella Agnoletti, Maria Gabriella Carmina, Massimo Chessa, Berardo Sarubbi, Maurizio Mongiovì, Maria Giovanna Russo, Sebastiano Bianca, Giuseppe Canzone, Marco Bonvicini, Elsa Viora, Marco Poli

Affiliations

  1. Pediatric Cardiology Unit, Maternity and Neonatal Department, ARNAS Garibaldi, Catania, Italy.
  2. Cardiology Department, PO Cervello, Az. Osp. Riuniti Villa Sofia-Cervello, Via Trabucco, 180, 90146 Palermo, Italy.
  3. Cardiology Department, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione 'Garibaldi', Catania, Italy.
  4. Pediatric Cardiology and Adult Congenital Heart Program, Azienda Ospedaliera-Universitaria Sant'Orsola-Malpighi, Bologna, Itlay.
  5. Genetics Unit, Maternity and Neonatal Department, ARNAS Garibaldi, Catania, Italy.
  6. Pediatric Cardiology Department, PO Di Cristina, ARNAS Civico, Palermo, Italy.
  7. Pediatric Cardiology Department, Ospedale Pediatrico Bambino Gesù, Roma, Italy.
  8. SCDU 2, Dipartimento di Scienze Chirurgiche (Surgical Sciences Department), Università di Torino, Italy.
  9. Pediatric Cardiology Department, Azienda-Ospedalliero-Universitaria Meyer, Firenze, Italy.
  10. Pediatric Cardiology Department, Ospedale Regina Margherita, Città della Salute e della Scienza, Torino, Italy.
  11. Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato Milanese San Donato Milanese (MI), Italy.
  12. Pediatric Cardiology and Cardiology SUN, Seconda Università di Napoli, AORN dei Colli, Ospedale Monaldi, Napoli, Italy.
  13. Women and Children Health Department, Ospedale S. Cimino, Termini Imerese (PA), Italy.
  14. Echography and Prenatal Diagnosis Centre, Obstetrics and Gynaecology Department, Città della Salute e della Scienza di Torino, Italy.
  15. Intensive Cardiac Therapy Department, Ospedale Sandro Pertini, Roma, Italy.

PMID: 28751846 PMCID: PMC5526477 DOI: 10.1093/eurheartj/sux032

Abstract

The success of cardiac surgery over the past 50 years has increased numbers and median age of survivors with congenital heart disease (CHD). Adults now represent two-thirds of patients with CHD; in the USA alone the number is estimated to exceed 1 million. In this population, many affected women reach reproductive age and wish to have children. While in many CHD patients pregnancy can be accomplished successfully, some special situations with complex anatomy, iatrogenic or residual pathology are associated with an increased risk of severe maternal and fetal complications. Pre-conception counselling allows women to come to truly informed choices. Risk stratification tools can also help high-risk women to eventually renounce to pregnancy and to adopt safe contraception options. Once pregnant, women identified as intermediate or high risk should receive multidisciplinary care involving a cardiologist, an obstetrician and an anesthesiologist with specific expertise in managing this peculiar medical challenge. This document is intended to provide cardiologists working in hospitals where an Obstetrics and Gynecology Department is available with a streamlined and practical tool, useful for them to select the best management strategies to deal with a woman affected by CHD who desires to plan pregnancy or is already pregnant.

Keywords: Cardiac complications; Cardiovascular disease; Congenital heart disease; Delivery; Pregnancy; Risk assessment

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