ANESTHESIA DURING DELIVERY WITH HEARTH DISEASE

Žene s kardiovaskularnim bolestima imaju rizik od srčanih komplikacija tijekom trudnoće i poroda. Srčane bolesti kompliciraju od 1 do 4 % trudnoća u žena bez postojećih abnormalnosti srca. Procjena rizika trebala bi se provesti kod tih žena, a liječenje u trudnoći i porodu treba planirati u skladu s tim. Trudnoća sama po sebi uzrokuje razne prilagodbe kardiovaskularnog sustava, kao naprimjer povećanje intravaskularnog volumena i povećanje srčanog minutnog volumena za 50%. Preeklampsija i eklampsija, koje kompliciraju čak do 15% trudnoća, su usko povezane s razvojem kardiovaskularnih bolesti u budućnosti. Također, novi rizični čimbenici za buduće kardiovaskularne bolesti uključuju majčinu pretilost i gestacijski dijabetes. Ovisno o tome koliki je rizik, žene bi trebale biti zbrinute u regionalnim centrima, stručnim centrima ili u kombinaciji oba. Multidisciplinarni timovi moraju biti uključeni u brigu o tim ženama. Odgovarajuća organizacija skrbi i komunikacija između članova tima važna je kako bi se spriječile moguće komplikacije.Women with cardiovascular disease have a risk of heart complications during pregnancy and childbirth. Heart disease complicates 1 to 4% of pregnancies without existing heart abnormalities. Risk assessment should be carried and treatment during pregnancy and childbirth should be planned accordingly. Pregnancy itself causes various adjustments to the cardiovascular system, such as increased intravascular volume and increased heart rate by 50%. Preeclampsia and eclampsia, which complicate around 15% of pregnancies, are closely related to the development of cardiovascular diseases in the future. Also, new risk factors for future cardiovascular disease include maternity obesity and gestational diabetes. Depending on the degree of a risk, care should be taken of in regional centers, vocational centers or in combination of both. Multidisciplinary teams need to be involved in taking care of these women. Appropriate organization of care and communication between team members is important to prevent possible complications