Use of Medication for Cardiovascular Disease During Pregnancy: JACC State-of-the-Art Review

J Am Coll Cardiol. 2019 Feb 5;73(4):457-476. doi: 10.1016/j.jacc.2018.10.075.

Abstract

Cardiovascular disease complicating pregnancy is rising in prevalence secondary to advanced maternal age, cardiovascular risk factors, and the successful management of congenital heart disease conditions. The physiological changes of pregnancy may alter drug properties affecting both mother and fetus. Familiarity with both physiological and pharmacological attributes is key for the successful management of pregnant women with cardiac disease. This review summarizes the published data, available guidelines, and recommendations for use of cardiovascular medications during pregnancy. Care of the pregnant woman with cardiovascular disease requires a multidisciplinary team approach with members from cardiology, maternal fetal medicine, anesthesia, and nursing.

Keywords: cardiovascular medications; gestation; pharmacokinetics; pregnancy.

Publication types

  • Review

MeSH terms

  • Breast Feeding
  • Cardiovascular Agents / pharmacokinetics
  • Cardiovascular Agents / therapeutic use*
  • Connective Tissue Diseases / complications
  • Female
  • Hematologic Agents / therapeutic use
  • Hemodynamics
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertension, Pulmonary / drug therapy
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Pregnancy Complications, Cardiovascular / etiology
  • Teratogens

Substances

  • Cardiovascular Agents
  • Hematologic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Teratogens