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1 Guidelines for Indication and Management of Pregnancy and Delivery in Women with Heart Disease (JCS 2005) Circulation Journal Vol. 69, Suppl. IV,
2 % % % ml % 500 ml von Willebrand Eisenmenger mmhg 3 NYHA 3 LVEF % 4 40mm % Therrien J, Dore A, Gersonny W, et al. CCS Consensus Conference 2001 update: recommendation for the management of adults with congenital heart disease. Part I. Can J Cardiol 2001; 17: Circulation Journal Vol. 69, Suppl. IV, 2005
3 guideline/guideline.html Down 22q11.2 Williams Holt-Oram Alagille Marfan QT Brugada Noonan LEOPARD 1.06 % 4.7 % 8.2 % 0.5 % 86.7 % % 2.4 % Non Stress Test NST Biophysical profile BPP Circ J 2003; 67: Supple IV; Circulation Journal Vol. 69, Suppl. IV,
4 g 1.5 mg kg 120 mg g 1g 1.0 g mg kg 120 mg g I 2.0 g g Circ J 2003; 67: Supple IV; Ebstein WPW Fontan % 1332 Circulation Journal Vol. 69, Suppl. IV, 2005
5 %, Eisenmenger 30 % 85 % 12 % Eisenmenger % 1 50 % 2 50 % 3 4 NYHA 75 % 40 % 1.5 cm 2 NYHA NYHA class 30 % mmhg mmhg NYHA NYHA NYHA NYHA NYHA NYHA 1.5 cm cm 2 5 mmhg 5 mmhg 75 % LVEF 40 % TIA Bonow RO, Carabello B, de Leon AC, et al. ACC AHA Guidelines for the Management of Patients With Valvular Heart Disease. A report of the American College of Cardiology American Heart Association Task Force on Practice Guidelines Committee on Management of Patients with Valvular Heart Disease Circulation. 1998;98: Circulation Journal Vol. 69, Suppl. IV,
6 mmhg Ross cystic medial necrosis % mg K % mg Circulation Journal Vol. 69, Suppl. IV, 2005
7 1C 1 3 D 12 informed consent 2B 3 B cystic medial necrosis % % mm 440 mm B mm NYHA 1 50 % 6 Circulation Journal Vol. 69, Suppl. IV,
8 % WPW 30 % QT 6.6 % 3.5 % % 50 % 80 % informed consent, 8 NYHA 40 % NYHA Intrauterine contraceptive devices IUD 1336 Circulation Journal Vol. 69, Suppl. IV, 2005
9 pregnancy induced hypertension; PIH preeclampsia gestational hypertension superimposed preeclampsia eclampsia mmhg 160 mmhg 300 mg 2 g 90 mmhg 110 mmhg 2 g 160mmHg mg dl 110mmHg 2 32 early onset type 32 late onset type 1gestational proteinuria chronic hypertension 3 HELLP 4 h H p P EO early onset type LO late onset type S superimposed type C Hp-EOhP-LO H-EOh-LO Hp-EOShP-LOS HP-EOSChP-LOSC g % % 58 % 81 Circulation Journal Vol. 69, Suppl. IV,
10 Metyldopa FDA B Clonidine FDA C Atenolol IUGR Propranolol Sotalol FDA B C Oxprenolol Metoprolol Labetalol IUGR 6 13 Hydralazine Non-Reassuring Fetal Status Ca Nifedipine Nicardipine Nicardipine MgSO4 Nifedipine Isosobide dinitrate Angiotensin Captoril Enalapril Cilazapril Lisinopril Angiotensin Candesartan Losartan Furosemide Spironolactone Anti-androgenic effects Thiazide % 92 % 94 % 3 non-reassuring fetal status IUGR 4 cm 2500 g Circulation Journal Vol. 69, Suppl. IV, 2005
11 Eisenmenger Food and Drug Administration Pregnancy Category 8 9 A B C D X Drugs facts and comparisons. St Louis MO Facts and Comparisons Circulation Journal Vol. 69, Suppl. IV,
12 FDA IA C IA C IA C IB B VT IB C VT IB D IC C VT SVT IC C VT SVT II C SVT VT Af II C SVT VT Af III D VT II III B VT SVT IV C SVT VT Af NA C SVT NA C SVT Af Vaughan Williams FDA ; 8 VTSVTAfNA Drugs facts and comparisons. St Louis MO : Facts and Comparisons Committee on Drugs: Transfer of drugs and other chemicals into human milk. Pediatrics 1994; 93: lidocaine mexiletine procainamide QT -blocker Circulation Journal Vol. 69, Suppl. IV, 2005
13 PDE III 10 FDA Circulation Journal Vol. 69, Suppl. IV,
14 Penicillins Ampicillin Monolactamics Aztreonam monocyclic lactamic antibiotics 11 Cephalosporins Cefsulodin Aminoglycosides Lincomycin Macrolides Erythromycin Estolate Tetracyclines Quinolones Amoxicillin Clavulanate AMPC Clavulanate potassium -lactamase inhibitor Potassium Chloramphenicol Gray baby Trimethoprim Glucose-6PD Sulfamethoxazole Kernicterus Sulfamids Metronidazole Vancomycin Fosfomycin 1 2 Nalidixic Acid Glucose-6PD Nitrofurantoin Glucose-6PD Antifungals AmphotericinB 5flucytosine Ketokonazole Antivirals Ganciclovir Isoniazid Rifampicin Gonzalez ML, Armada RE, Diaz RJ, et al.practice Guidelines of the Spanish Society of Cardiology for the management of cardiac disease in pregnancy. Rev Esp Cardiol. 2000;53: Spanish 1342 Circulation Journal Vol. 69, Suppl. IV, 2005
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2001 2002 Guidelines for perioperative cardiovascular evaluation and management for noncardiac surgery (JCS 2003) 1 2 3 1 2 3 4 5 6 7 8 9 Circulation Journal Vol. 67, Suppl. IV, 2003 1239 2001 2002 13
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