ABSTRACT: Reproductive-aged women with structural heart disease who become pregnant as well as postreproductive-aged women with this condition represent a significant proportion of patients seen by obstetrician–gynecologists. Usually, their conditions are complex, and a basic knowledge of the anatomy and physiology of the heart is required. Additionally, understanding the effect of pregnancy on women with structural heart disease is critically important to optimizing maternal and fetal outcomes. This monograph addresses the pathophysiology, signs and symptoms, screening and diagnosis, basic management, and suggested counseling for an obstetric–gynecologic patient with structural heart disease.
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Subscribe![Figure 1. Normal pattern of blood flow through the heart: A. fetal circulation before birth; arrows indicate the direction of blood flow; oxygenated blood mixes with deoxygenated blood in the liver (I), the inferior vena cava (II), the right atrium (III), the left atrium (IV), and at the entrance of the ductus arteriosus into the descending aorta (V), B. human circulation after birth. (Sadler TW. Langman’s medical embryology. 13th ed. Philadelphia [PA]: Wolters Kluwer; 2015.)](/-/media/project/acog/acogorg/clinical/images/clinical-updates/2017/03/structuralheartdisease/cu076-20170300-fig1.png)
