Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Parents of 751 children affected by cancer/leukemia, congenital heart disease, strawberry nevus or mental retardation have been investigated with respect to their reproductive history and their exposure to risk factors for spontaneous abortion. Differences between the four groups were established for the number of children in the sibship, the proportion of multigravidae and the spontaneous abortion rate among these women. The greatest differences were observed in the two groups of malformed children compared with the other two groups, being as marked in those with a severe malformation (heart defect) as in those with a benign one (strawberry nevus). Taking known risk factors for spontaneous abortion into account did not explain the observed differences. An etiological hypothesis is put forward which takes account of the high proportion of quantitative abnormalities of the karyotype associated with congenital heart disease and spontaneous abortion.
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PMID:Spontaneous abortions in sibship of children with congenital malformation or malignant disease. 26 88

Most cardiovascular problems in pregnant women arise from the complications of preexisting chronic conditions (e.g., rheumatic and congenital heart disease) and hypertensive vascular disease. Regular supervision of these patients is essential to detect incipient pulmonary congestion or disturbances of cardiac rhythm. Even if the pregnancy has been uncomplicated, hospital admission 1-4 weeks before the due date is recommended to ensure optimal conditions for labor. Vaginal delivery at term with adequate sedation and use of forceps to shorten the 2nd stage of labor is the perferred mode. Induction of labor may be indicated in hypertensive vascular disease or in cases where adjusting or discontinuing drug therapy calls for precise timing of delivery. Eisenmenger's disease and primary hypertension are potential medical indications for pregnancy termination. The distribution pattern of organic heart disease encountered in pregnant women has changed in the past 20 years, with a decrease in rheumatic and an increase in congenital heart disease. The incidence of chronic rheumatic heart disease in pregnant women fell from 3.5% of all deliveries at Newcastle General Hospital in 1942-51 to 1.1% in 1962-71. Acute pulmonary edema in mitral stenosis is currently a major risk during pregnancy. There is no optimal stage of pregnancy for valvotomy, nor evidence that this procedure induces miscarriage in the early weeks. Pregnancy has become less hazardous in severe forms of congenital heart disease as more patients with these disorders have undergone cardiac surgery prior to pregnancy. Pregnancy is not believed to have any effect on the longterm course of rheumatic heart disease. Patients with aortic stenosis, coarctation of the aorta, primary pulmonary hypertension, Fallot's tetralogy, Eisenmenger's syndrome, and surgically untreated cyanotic lesions require special attention during pregnancy. The outlook for women who become pregnant after an acute cardiac infarction episode depends on the functional state of the heart at the time of pregnancy and the presence or absence of angina pain. There has been a gradual decline in perinatal mortality, especially in cases complicated by rheumatic heart disease.
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PMID:Cardiac disorders. 34 Jan 1

The early diagnosis of heart disease during or better before pregnancy is one of the most important problems, as cardiac diseases are the most common cause for maternal deaths throughout the world. The knowledge of hemodynamic alterations in circulatory and respiratory physiology during pregnancy complicated by heart disease is a prerequisite for their management. The following indications for therapeutic abortion of pregnancy complicated by heart disease can be concluded according to our own observations: 1. history of significant heart failure (more than grade IV according to the classification of the New York Heart Association), frequent attacks of angina pectoris and longstanding cyanosis: 2. in spite of the most careful heart treatment with digitalis, diuretics and salftree diet cardiac-thorax-rate of more than 55% in congenital heart disease, cardiac-thorax-rate of more than 60% in acquired heart disease, significant signs of heart failure, namely more severe than grade III, tachycardic atrial fibrillation, pulse deficit of more than 30/min, active inflammatory processes of the heart (rheumatic fever, subacute bacterial endocarditis, Takayasu's disease); 3. especially severe metabolic disorders, i.e. diabetes mellitus, malignant hypertension, kidney diseases; 4. primiparae of an age of more than 35 years with any heart disease. Commissurotomy can be accomplished during pregnancy if it is too late for therapeutic abortion. Pregnancy in case of artificial valves is not recommended in general because of impending hemorrhagic diathesis.
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PMID:[Indication for pregnancy interruption in patients with heart diseases]. 85 89

108 women with congenital heart disease in child-bearing age (16-38 years, mean age 28) were followed up for a period of ten years. Possible complications of contraceptive methods, and incidence of full-term pregnancies, spontaneous abortions and cardiovascular complications during pregnancy and delivery, were considered. Half of these patients had a cyanotic congenital heart disease, 23 had left-to-right shunt mainly at atrial level, 18 had right and 14 left ventricular outflow tract obstruction. 60 women had previous surgical procedures for their congenital heart disease. 83% of the patients were in NYHA functional class I-II. No complications were found during oral contraceptive regimen during intrauterine device insertion with antibiotic prophylaxis, except for the development of pulmonary hypertension in one patient with an atrial septal defect. 146 pregnancies occurred, but only 89 were full-term. There was a high number of interrupted pregnancies, rarely for medical reasons. The incidence of spontaneous abortion was similar to that of normal population (18% versus 10-15%). Maternal cardiovascular complications were found in the 22% of the full-term pregnancies, but were well controlled by medical treatment. In conclusion, good family planning and pregnancies are possible in most young females with congenital heart disease. In the absence of cyanosis and pulmonary hypertension, oral contraception does not carry any particular risk. With appropriate medical care intrauterine devices may be an alternative in high risk patients. In the presence of a good cardiac function, a normal full-term pregnancy with an healty baby is the rule. A cesarean section is seldom needed.
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PMID:[Risks of contraception and pregnancy in patients with congenital cardiopathies. Retrospective study on 108 patients]. 129 7

To test the effect of maternal habits and home exposures during early pregnancy on the occurrence of congenital heart disease in the offspring, 406 cases and 756 controls were studied. The cases included all cardiovascular malformations detected in Finland during 1982-1983, while the healthy controls were randomly selected from all babies born during the same period. Case and control mothers were interviewed after delivery using a structured and pre-tested questionnaire. Maternal overall drug consumption during the first trimester was as prevalent among case mothers (13.3%) as controls (14.6%). Neither was the risk of congenital heart disease associated with maternal use of contraceptive pills, salicylates, diazepam, or sweetening agents separately. Maternal exposures to disinfectants, dyes, lacquers, paints, pesticides, or glues at home were equally prevalent in case and control groups. Several earlier miscarriages was a predictor of an infant born with congenital heart disease (OR = 2.7, CI95 = 1.4-5.3). Maternal ultrasound examination was performed during the first 16 weeks of pregnancy more often among the case group (28.3%) than among the control group (22.0%). However, the association between ultrasound examination and the risk of congenital heart disease in the offspring was not statistically significant (OR = 1.2, 95% confidence interval 0.9-1.7) when adjusted for confounding factors such as the threat of miscarriage in logistic regression analysis. It is concluded that maternal ultrasound examination, intake of some common drugs, and exposure to a number of environmental factors at home during early pregnancy are probably not harmful for the developing fetal heart.
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PMID:Congenital heart disease in the offspring and maternal habits and home exposures during pregnancy. 146 49

58% of currently married women in Japan were current users of contraception in 1990. The condom was the most popular method, with a use rate of 43%, followed by natural family planning methods (9%). The unusual popularity of the condom is, in part, explained by the nonavailability of oral contraceptives (OCs); the pill is illegal in Japan because of government concerns about its side effects. However, the Ministry of Health has given Japanese pharmaceutical companies permission to develop a low-dose OC assumed to lower the risks of hypertension, stroke, and heart disease that should become available soon. In anticipation of this move, the 1986 and 1990 National Surveys on Family Planning asked respondents their views on OC legalization and whether they would become acceptors. 10% of women in both surveys indicated they intended to use the pill and another third were uncertain. Intention to use the pill was related to recognition of its high effectiveness and a desire to reduce the need for abortion. 29% of respondents in the 1990 survey reported a least 1 abortion, and 25% had been using contraception at the time their last pregnancy occurred. Logit regression revealed that intent to seek abortion in the event of another pregnancy and joint family type were the only factors, after adjustment, significantly associated with planned OC use; age, educational level, and employment status were not significant. The surveys further revealed a need to reassure Japanese women about the pill's safety if acceptance rated exceeding 10% are to be achieved. 13% of 1986 respondents and 21% of those interviewed in 1990 stated opposition to legalization of the pill and 48% in both surveys were uncertain. 77% of women in the 1986 survey and 70% of those in 1990 cited concerns about pill safety as a reason for their opposition.
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PMID:Prospects for increased contraceptive pill use in Japan. 179 77

This study was carried out to assess the problems with the pregnant women, and check out the risk-factors in the high-risk pregnancies, using a simplified antepartum risk-scoring system, which was revised from Edwards' scoring system to be suitable for Korean situation. This instrument was included 4 categories, demographic, obstetric, medical and miscellaneous factors. This survey was based on the 1300 pregnant women who were admitted, from Jan. 1, 1988, to May 31, 1990, Chung Ang Medical Center. Data were collected from June 25, 1990 to July 7, 1990. Data was analyzed by x2-test, F-test, Pearsons correction, using statistical package SAS in NAS computer system, KIST. The results of the study were as follows; 1. 1313 infants were deliveried of these 560 infants (42.7%) were born to mothers with risk-scores greater than 7, and 753 infants (57.3%) were born to mothers risk-scores less than 7. 2. Maternal age, parity, education level, of the demographic factors were significant relation statistically to identify the high risk pregnancies (X2 = 20.88, 42.87, 15.60 P less than 0.01). 3. C-section, post term, incompetent cervix, uterine anomaly, polyhydramnios, congenital anomaly, sensitized RH negative, abortion, preeclampsia, excessive size infant, premature, low birth weight infant, abnormal presentation, perinatal loss, multiple pregnancy, of the obstetric factors were significant relation statistically to identify the high risk-pregnancies. (chi 2 = 175.96, 87.5, 16.28, 21.78, 9.46, 8.10, 6.75, 22.9, 64.84, 6.93, 361.43, 185.55, 78.65, 45.52, P less than 0.01). 4. Abnormal nutrition, anemia, UTI, other medical condition (pulmonary disease, severe influenza), heart disease, V.D., of the miscellaneous and medical factors, were significant relation statistically to identify the high risk-pregnancies. 5. Premature, low birth weight infant, contracted pelvis, abnormal presentation, of the risk factors were significantly related with Apgar score at 1 & 5 minute after birth and neonatal body weight. 6. Apgar score at 1 & 5 minute after birth and neonatal body weight were significantly negative correlated with risk-score. 7. There were statistically significant difference between risk-score and Apgar score at 1 & 5 minute after birth, 3 group (0-3, 4-6, above 7), and neonatal body weight, 2 group (below 2.5 kg, the other group) (F = 104.65, 96.61, 284.92, P less than 0.01). 8. Apgar score at 1 & 5 minute after birth (below 7), and neonatal body weight (below 2.5 kg), were significant relation statistically with risk score. (chi 2 = 65.99, 60.88, 177.07, P less than 0.01) were 60.8%, 60%.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The identification of high-risk pregnancy, using a simplified antepartum risk-scoring system]. 192 Dec 77

The clinical profile of right-sided infective endocarditis in India was studied from a review of records of patients with infective endocarditis admitted to this hospital. From November 1982 to November 1989, 109 patients with infective endocarditis showed vegetations on cross-sectional echocardiography confirming the diagnosis of infective endocarditis. In 19 (17.4%) patients, only the right side of the heart was involved: specifically the tricuspid valve alone in 10; tricuspid and pulmonary valves in 4; tricuspid valve and right ventricular outflow tract in 1; tricuspid valve and right ventricular free wall in 1; pulmonary valve alone in 2; and bifurcation of pulmonary trunk in 1. Eleven patients (57.9%) had underlying congenital heart disease whereas the remaining 8 patients (42.1%) did not have any underlying heart disease. The latter group, therefore, had isolated right-sided infective endocarditis. Previous illnesses leading to isolated right-sided infective endocarditis were: puerperal sepsis in 4; septic abortion in 1; staphylococcal pneumonia in 2; and epididymoorchitis in one. Eight out of 11 patients with congenital heart disease did not report any previous illness. In the remaining 3, right-sided endocarditis followed cardiac surgery in one; dental extraction without prophylaxis in one; and pulmonary balloon valvoplasty in one. All patients with isolated right-sided infective endocarditis had features of septicaemia, but a murmur of tricuspid regurgitation was audible in only 4 (50%) of them. We conclude that, unlike western reports, the pattern of right-sided infective endocarditis in India is different. No drug addict with right-sided infective endocarditis was seen; puerperal sepsis and septic abortion were the commonest causes of isolated right-sided infective endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Profile of right-sided endocarditis: an Indian experience. 193 86

This study compares the risks of pregnancy, infertility, heart disease, cancer, and death associated with various contraceptive methods with the risks faced by women using no method. Estimated risks are derived from a decision-tree analysis program for a hypothetical cohort of 100,000 women. Method-specific estimates of the probability of various outcomes were obtained from published reports. Low estimates of typical use, first-year failure rates were used in the models. Tabulated data reveal that women who use no contraceptive method throughout their reproductive life (aged 15-44) and never have an abortion would have 18 births as compared to no more than five for women who use any contraceptive method. Data were also tabulated for the method-specific risks of developing upper genital tract infections, ectopic pregnancies, and tubal infertility (caused by the acquisition of a sexually transmitted disease [STD]) were calculated with method differences modeled for women at high and at low risk of acquiring a STD. The third table shows the estimated annual number of deaths per 100,000 ectopic pregnancies, live births, and induced abortions by five-year age groups. The annual pregnancy-related and method-related mortality rates per 100,000 women at risk of unintended pregnancy and at low risk of STDs was also calculated by contraceptive method. The fifth table illustrates the estimated annual incidence of and number of deaths from cardiovascular diseases per 100,000 women by smoking status, age group, and use of nonuse of oral contraceptives. OC use is also compared in a determination of the estimated annual number of ovarian, endometrial, and breast cancers diagnosed per 100,000 women by age at diagnosis. Finally, estimated deaths averted by each age group annually per 100,000 were calculated for current users of barrier and spermicide methods and of OCs and for ever-users before age 45. The conclusions drawn from these comparisons are that each contraceptive method presents different combinations of risks and benefits to women at different stages of their lives. Engaging in multiple sexual relationships, smoking, and irregular or incorrect method use are the three factors which most compromise a woman's ability to reach her reproductive and health goals.
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PMID:Comparing the health risks and benefits of contraceptive choices. 206 Jun 12

Heart disease is the most important nonobstetric cause of maternal death; however, most young women with heart disease do well during pregnancy. If the physician is uncertain of the effects of pregnancy on a particular heart condition, needless restrictions may be imposed. The main hazards are: pulmonary edema when it occurs suddenly in mitral stenosis; pulmonary hypertension (because pulmonary vascular disease tends to be exacerbated by pregnancy); infective endocarditis (this is rare); and fulminating peripartum cardiomyopathy. The practical management of the pregnant patient with various concomitant heart conditions (congenital heart disease, pulmonary hypertension, rheumatic heart disease, anticoagulants and artificial valves, constrictive pericarditis, kyphoscoliosis, Marfan's syndrome, mitral prolapse, hypertrophic cardiomyopathy, dilated cardiomyopathy, infective endocarditis, and arrhythmias) is discussed. An absolute indication for therapeutic abortion is severe pulmonary vascular disease; discretionary indications include 'chronic thromboembolic pulmonary hypertension,' cardiomyopathies (depending on the hemodynamic disturbance), and Marfan's syndrome.
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PMID:Cardiovascular disease in pregnancy. 218 16


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