Pregnancy
Ante
partum
Ante
partum
Ante
partum
EKG changes
Left axis deviation by 15
Low voltage QRS
T wave inversion in lead III
Q waves in lead III dan aVF
Premature atrial dan ventricular beats
Chest x-ray changes
Horizontal position of heart
Small pleural effusions early postpartum
Intra
partum
Post
partum
Normal
Abnormal
- Fatigue
- Syncope
- Dyspnea
- Occasional palpitations
- Sustained arrhythmia
- Summation gallop
- Systolic murmur (46/6)
- Diastolic murmur
- Chest pain
- Hemoptysis
- Cyanosis
8
2. Class II
Slight limitation of physical activity: These women
are comfortable at rest, but if ordinary physical
activity is undertaken, discomfort results in the form
of excessive fatigue, palpitation, dyspnea, or anginal
pain
Cardiac Disease in Pregnancy
4. Class IV
Severely compromised (inability to perform any
physical activity without discomfort): Symptoms of
cardiac insufficiency or angina may develop even at
rest, and if any physical activity is undertaken,
discomfort is increased.
Cardiac Disease in Pregnancy
10
Mortality
< 1%
11
Mortality
5-15%
involvement
Fallot tetralogy, uncorrected
Marfan syndrome, normal aorta
Mechanic Prosthetic valve
Mitral stenosis, NYHA class III and
IV
Aortic stenosis
Previous myocardial infarction
Cardiac Disease in Pregnancy
12
Pulmonary hypertension
Aortic coarctation with valvular
involvement
Marfan syndrome with aortic
involvement
Peripartum Cardiomopathy
Mortality
25-50%
13
14
Management
Prakonsepsi
15
management
Antepartum
16
management
Intrapartum
17
management
Postpartum
18
Management
Selama
kehamilan
perhatikan
Bed rest
Restriksi cairan
Diet rendah garam
Pemberian obat golongan diuretik
Dapat ditambahkan obat golongan
vasodilator dan digitalis
Pemberian antikoagulan profilaksis
selama kehamilan dilnjutkan dengan
dosis penuh selama 7-10hari
postpartum
Percepat kala II
19
Kontrasepsi
Jenis
Barier/kondom
Pil oral kontrasepsi
Kontrasepsi bebas estrogen
IUD
Tubektomi/vasektomi
20
The End
21