Enfoque de la paciente embarazada con enfermedad valvular cardiaca
Resumen
Las mujeres con enfermedad valvular que están embarazadas o planean embarazarse requieren cuidadosa evaluación y manejo. El embarazo se asocia con cambios fisiológicos que pueden agravar muchas enfermedades valvulares. La mayoría de mujeres toleran bien el embarazo y el parto sin complicaciones mayores; sin embargo, algunos tipos de enfermedad valvular son mal tolerados y requieren manejo intensivo. Además las pacientes con riesgo de tromboembolismo y aquellas con prótesis valvulares requieren anticoagulación y la decisión respecto al tipo e intensidad de la anticoagulación, requiere un cuidadoso balance entre el riesgo individual de trombosis y sangrado en la madre y los peligros para el feto. La clave para optimizar los buenos resultados en las pacientes con enfermedad valvular cardiaca consiste en un diagnóstico exacto de la etiología, en la clasificación del riesgo, en la adecuada evaluación y consejería antes de la gestación y la referencia de las mujeres de alto riesgo a centros con experiencia. El manejo de estas pacientes debe ser multidisciplinario con un equipo que incluya especialistas en las áreas de obstetricia, cardiología, neonatología y anestesiología entre otros.Descargas
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