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What is Which of the following cardiac diseases is associated with safe pregnancy? and explain in detail?
Ans-A (Congenital cyanotic heart disease) Ref: DC Dutta's Textbook of Obstetrics, pg: 275Explanation:Absolute indications for therapeutic termination in maternal heart diseases during pregnancy:Primary pulmonary hypertension.Eisenmenger's syndrome.Pulmonary veno-ocdusive disease.WHO Cardiovascular Risk ClassificationRisk classCardiovascular conditionsIUncomplicated, small or mild:* Pulmonary stenosis* Patent ductus arteriosus* Mitral valve prolapse Successfully repaired simple lesions (ASD, VSD. PDA), anomalous venous drainageAtrial or ventricular ectopic beatsII (well and uncomplicated)* Unoperated ASD or VSD* Repaired tetralogy of Fallot* Most arrhythmiasII-III* Mild left ventricular impairment* Hypertrophic cardiomyopathy* Native or tissue valvular heart disease not considered WHO I or IV* Marfan syndrome without aortic dilatation* Aorta <45 mm Hg in aortic disease with bicuspid aortic valve* Repaired aortic coarctationIII* Mechanical valve* Systemic right ventricle* Fontan circulation* Cyanotic heart disease (unrepaired)* Aortic dilatation 40-45 mm in Marfan syndrome; 45-50 mm aortic disease associated with the bicuspid aortic valveIV (Pregnancy contraindicated)* Pulmonary arterial hypertension* Severe systemic ventricular dysfunction (LVEF G0.30, NYHA III-IV)* Previous peripartum cardiomyopathy with any residual impairment of left ventricular function* Severe mitral stenosis* Severe symptomatic aortic stenosis* Marfan syndrome with aorta dilated {>45 mm)* Aortic dilation >50 mm in aortic disease associated with the bicuspid aortic valve* Native severe coarctation