Trudnoća u bolesnica s prirođenim srčanim greškama

master's thesis

• Title (english): Pregnancy in patients with congenital heart defects
• Author: Lea Jerkić
• Mentor: Eduard Margetić (mentor)
• Committee member: Boško Skorić (predsjednik povjerenstva)
• Committee member: Martina Lovrić Benčić (član povjerenstva)
• Committee member: Eduard Margetić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Unazad nekoliko desetljeća prirođene srčane greške bile su zastupljene pretežno u pedijatrijskoj populaciji, no danas zahvaljujući velikom napretku medicinske skrbi i kirurgije većina bolesnica s prirođenim srčanim greškama doživi reproduktivnu dob.
Kako bi se osigurala što kvalitetnija skrb za bolesnice s prirođenim srčanim greškama koje priželjkuju trudnoću osnivaju se kardioopstetrički timovi. Kardioopstetrički tim čine kardiolog specijaliziran za područje prirođenih srčanih grešaka, opstetričar, anesteziolog, neonatolog te stručnjaci iz drugih područja medicine. Pretkoncepcijsko savjetovanje i procjenu rizika za majku i dijete treba provesti prije planiranja trudnoće. Rizik od kardiovaskularnih komplikacija u trudnoći najviše ovisi o težini prirođene srčane greške u bolesnice. Bolesnice s prirođenim srčanim greškama treba informirati o maternalnom i fetalnom mortalitetu i morbiditetu, o riziku nasljeđivanja prirođene srčane greške u potomstva, dugotrajnom utjecaju trudnoće na njihovo zdravstveno stanje i potrebi liječenja i medicinskih intervencija tijekom trudnoće. Nakon procjene rizika, potrebno je napraviti plan praćenja tijekom trudnoće, isplanirati način i vrijeme porođaja te skrb za bolesnicu u potpartalnom razdoblju. Iako trudnoća predstavlja izvjestan rizik za bolesnice s prirođenim srčanim greškama, većina ovih bolesnica uz adekvatnu medicinsku skrb uspije uspješno iznijeti trudnoću.

Abstract (english)

A few decades ago, congenital heart defects were a disease of the pediatric population. Advances in medical and surgical treatments have led to improvement in the survival of these patients to adulthood and the majority of affected female patients now reach childbearing age.
Women with congenital heart disease who desire pregnancy, require a multidisciplinary team approach that can be accomplished through cardio-obstetrics teams. The cardio-obstetrics teams include specialists in obstetrics, adult congenital cardiology, fetal medicine, anesthesia, and other medical fields. Preconception counseling and evaluation of risks for both mother and the fetus should be performed before planning pregnancy. The risk of cardiovascular complications during pregnancy mostly depends on the type of the underlying defect. Women should be informed about maternal and fetal morbidity and mortality, the risk of recurrence of heart disease in the offspring, the long-term impacts of pregnancy on maternal health, and the need for treatment and medical interventions during pregnancy. After the estimation of risks, a detailed follow-up plan during pregnancy and delivery as well as post-partum management plan should be made. Even though pregnancy poses substantial risk for women with congenital heart defects, most women can successfully carry out pregnancy with adequate medical care.

• Keywords: trudnoća; prirođene srčane greške; kardioopstetrički tim; pretkoncepcijsko savjetovanje; procjena rizika
• Keywords (english): pregnancy; congenital heart defects; cardio-obstetrics team; preconception counseling; risk estimation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:192797
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-10 12:56:43