Background and objecives: Adverse cardiovascular outcomes during pregnancy have increased over the past few decades, with increased numbers of women delivering later in their reproductive life. Other factors include higher rates of female obesity, diabetes, hypertension, cardiovascular diseases and assisted reproductive technology, which has extended fertility. Those at risk require extensive prenatal maternal screening, constant pregnancy supervising, monitoring during labor, delivery and puerperium and careful anesthetic evaluation during delivery. Materials and Methods: The present review reports the relevant information available on cardiovascular outcomes in advanced maternal age delivering women and related medico-legal issues. The search was performed on Pubmed, Cochrane, Semantic Scholar, Medline and Embase databases, accessed by Ovid, including among others the terms “cardiomyopathy”, “ischaemic heart disease”, “arrhythmias”, “hypertension”, “peripartum period”, “diabetes”, “advanced maternal age” “anesthesia”, “maternal morbidity and mortality” and “litigation”. Results: To the extent that underestimating risk factors for peripartum cardiomyopathy (PPCM) can adversely impact maternal and fetal outcomes, the legal implications of misdiagnosis or mismanagement can result in high compensatory damages. Substantial indemnity payments drive up costs of insurance coverage. Conclusions: Multidisciplinary approaches are necessary from obstetricians, cardiologists, anesthesiologists and perinatologists for pregnancy monitoring and delivery outcomes.

Cardiovascular outcomes in advanced maternal age delivering women. Clinical review and medico-legal issues / De Viti, D.; Malvasi, A.; Busardo, F.; Beck, R.; Zaami, S.; Marinelli, E.. - In: MEDICINA. - ISSN 1010-660X. - 55:10(2019). [10.3390/medicina55100658]

Cardiovascular outcomes in advanced maternal age delivering women. Clinical review and medico-legal issues

Zaami S.
Penultimo
;
Marinelli E.
Ultimo
2019

Abstract

Background and objecives: Adverse cardiovascular outcomes during pregnancy have increased over the past few decades, with increased numbers of women delivering later in their reproductive life. Other factors include higher rates of female obesity, diabetes, hypertension, cardiovascular diseases and assisted reproductive technology, which has extended fertility. Those at risk require extensive prenatal maternal screening, constant pregnancy supervising, monitoring during labor, delivery and puerperium and careful anesthetic evaluation during delivery. Materials and Methods: The present review reports the relevant information available on cardiovascular outcomes in advanced maternal age delivering women and related medico-legal issues. The search was performed on Pubmed, Cochrane, Semantic Scholar, Medline and Embase databases, accessed by Ovid, including among others the terms “cardiomyopathy”, “ischaemic heart disease”, “arrhythmias”, “hypertension”, “peripartum period”, “diabetes”, “advanced maternal age” “anesthesia”, “maternal morbidity and mortality” and “litigation”. Results: To the extent that underestimating risk factors for peripartum cardiomyopathy (PPCM) can adversely impact maternal and fetal outcomes, the legal implications of misdiagnosis or mismanagement can result in high compensatory damages. Substantial indemnity payments drive up costs of insurance coverage. Conclusions: Multidisciplinary approaches are necessary from obstetricians, cardiologists, anesthesiologists and perinatologists for pregnancy monitoring and delivery outcomes.
2019
pregnancy; advanced maternal age; cardiovascular outcomes; peripartum cardiomyopathies (PPCM); hypertension; diabetes; arrhythmias
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Cardiovascular outcomes in advanced maternal age delivering women. Clinical review and medico-legal issues / De Viti, D.; Malvasi, A.; Busardo, F.; Beck, R.; Zaami, S.; Marinelli, E.. - In: MEDICINA. - ISSN 1010-660X. - 55:10(2019). [10.3390/medicina55100658]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1477657
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