Читать книгу Managing Medical and Obstetric Emergencies and Trauma - Группа авторов - Страница 42

Deaths from cardiac disease have been rising and this is now the leading cause of maternal death in the UK, with approximately 50 deaths in each triennium. In 2015–2017 only four were due to congenital heart disease. The leading causes were sudden adult death syndrome, myocardial infarction, dissection of the thoracic aorta and myocardial disease (including cardiomyopathies). Only a quarter of women who died from heart disease were known to have cardiac problems prior to pregnancy, and symptoms such as breathlessness were frequently misattributed to pregnancy. A third of the women who died from cardiac disease had a BMI of 30 or more. The main learning point from all these cases was that there must be a low threshold for investigation of pregnant or recently delivered women who complain of chest pain or breathlessness, especially if they have risk factors such as hypertension. Women with cardiac disease should be cared for by obstetricians, cardiologists and obstetric anaesthetists in a coordinated fashion, with combined clinics being the gold standard.