2003 2004 Guidelines for Indication and Management of Pregnancy and Delivery in Women with Heart Disease (JCS 2005) 1 2 1 2 3 4 5 6 3 1 1 2 3 4 5 6 7 8 9 2 1 2 3 4 Circulation Journal Vol. 69, Suppl. IV, 2005 1329
2003 2004 5 6 3 1 2 3 4 1 10 32 40 50 % 32 20 % 20 24 20 24 30 50 % 300 500 ml 15 25 % 500 ml 2 4 6 von Willebrand 2 1 1 1 1 Eisenmenger 240 50 mmhg 3 NYHA 3 LVEF 35 40 % 4 40mm 5 685 % 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: 940-59 2 3 1330 Circulation Journal Vol. 69, Suppl. IV, 2005
http://www.kuhp.kyoto-u.ac.jp/idennet/idensoudan/ 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 % 1.1 14.1 % 2.4 % 3 16 2 3 26 3 4 35 2 1 4 Non Stress Test NST Biophysical profile BPP 18 22 5 2 3 6 2 1 2 3 Circ J 2003; 67: Supple IV; 1039-110. Circulation Journal Vol. 69, Suppl. IV, 2005 1331
2003 2004 3 2.0 g 1.5 mg kg 120 mg 30 6 1 g 1g 1.0 g 1 2 1.5 mg kg 120 mg 30 2.0 g I 2.0 g 30 1.0 g 1 2 30 68 Circ J 2003; 67: Supple IV; 1039-110. 1 1 Ebstein WPW Fontan 10 25 % 1332 Circulation Journal Vol. 69, Suppl. IV, 2005
%, Eisenmenger 30 % 85 % 12 % Eisenmenger 30 70 % 1 50 % 2 50 % 3 4 NYHA 75 % 40 % 1.5 cm 2 NYHA NYHA class 30 % 4 40 50 mmhg 40 50 mmhg NYHA NYHA NYHA NYHA NYHA NYHA 1.5 cm 2 1.5 cm 2 5 mmhg 5 mmhg 75 % LVEF 40 % TIA 20 35 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;98:1949-1984 Circulation Journal Vol. 69, Suppl. IV, 2005 1333
2003 2004 40 50 mmhg Ross cystic medial necrosis 1 1 4 % 6 13 5 mg K 12 24 % 14 36 1 1 5mg 6 12 14 13 15 33 35 34 36 1334 Circulation Journal Vol. 69, Suppl. IV, 2005
1C 1 3 D 12 informed consent 2B 3 B cystic medial necrosis 4 5 5 30 % 5 1 50 % 2 344 mm 440 mm B 5 6 7 10 17.3 374 30 mm NYHA 1 50 % 6 Circulation Journal Vol. 69, Suppl. IV, 2005 1335
2003 2004 6 60 % WPW 30 % QT 6.6 % 3.5 % 7 1 1 33 2 21 50 % 50 % 80 % 13 3 1 12 informed consent, 8 NYHA 40 % NYHA 9 17 4 6 7 2 1 Intrauterine contraceptive devices IUD 1336 Circulation Journal Vol. 69, Suppl. IV, 2005
6 2004 1 pregnancy induced hypertension; PIH 2 20 12 3 1 1 preeclampsia 20 12 2 gestational hypertension 20 12 3 superimposed preeclampsia 1 20 20 2 20 20 3 20 20 4 eclampsia 20 3 2 1 24 140 mmhg 160 mmhg 300 mg 2 g 90 mmhg 110 mmhg 2 g 160mmHg 3+ 300 mg dl 110mmHg 2 32 early onset type 32 late onset type 1gestational proteinuria 20 12 2chronic 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 2 1000 g 28 25 75 % 22 1 27 % 58 % 81 Circulation Journal Vol. 69, Suppl. IV, 2005 1337
2003 2004 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 7 1 2 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 37 1338 Circulation Journal Vol. 69, Suppl. IV, 2005
20 30 34 36 37 1 1.5 4 2 5 Eisenmenger 6 3 1. 3 Food and Drug Administration Pregnancy Category 8 9 A B C D X 8 3.. 3.......... Drugs facts and comparisons. St Louis MO Facts and Comparisons. 1997 Circulation Journal Vol. 69, Suppl. IV, 2005 1339
2003 2004 9 1 2 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. 1997 Committee on Drugs: Transfer of drugs and other chemicals into human milk. Pediatrics 1994; 93: 137-50. 9 lidocaine mexiletine procainamide QT -blocker 2 10 1340 Circulation Journal Vol. 69, Suppl. IV, 2005
2 1 2 2 2 1 2 1 2 1 2 1 1 12 1 12 PDE III 10 FDA 8 2 1 2 2 1 2 3 11 4 18 16 20 24 28 Circulation Journal Vol. 69, Suppl. IV, 2005 1341
2003 2004 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 12 28 Gray baby Trimethoprim 12 28 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: 1474-1495 Spanish 1342 Circulation Journal Vol. 69, Suppl. IV, 2005