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Complications of Pregnancy

  Pregnancy complications can cause additional burden on the heart due to pregnancy and childbirth, which can further reduce cardiac function and even cause serious consequences. The total blood volume increases during pregnancy, and the cardiac output increases significantly. The peak of cardiac work is between 32-34 weeks, the heart rate increases, and the uterus increases, the diaphragm rises, and the heart shifts up and to the left, all of which mechanically increase the cardiac burden. During the delivery period, uterine contractions cause a periodic increase in cardiac output, especially during the second stage of labor, where the mother holds her breath, peripheral vascular resistance increases, and visceral blood rushes to the heart, the cardiac burden is the heaviest, and pregnant women with poor cardiac function are more likely to develop heart failure. Within 24-48 hours after delivery, the uterus gradually shrinks, a large amount of blood enters the systemic circulation, and tissue fluid also begins to return to the blood circulation, increasing the cardiac burden and making it more likely to develop heart failure.

 

Table of Contents

1. What are the causes of pregnancy complications
2. What complications can pregnancy complications easily lead to
3. What are the typical symptoms of pregnancy complications
4. How to prevent pregnancy complications
5. What laboratory tests need to be done for pregnancy complications
6. Dietary taboos for patients with pregnancy complications
7. Conventional methods of Western medicine for the treatment of pregnancy complications

1. What are the causes of the onset of pregnancy complications?

  1. Congenital heart disease:May be related to the diseases or drugs taken by the mother in the early stage of pregnancy; related to heredity.

  2. Coronary heart disease:Smoking, diabetes, hypertension, and other factors lead to vascular sclerosis and narrowing, causing blood flow obstruction and making myocardial hypoxia and damage more likely.

  3. Rheumatic heart disease:Mainly due to the gradual pathological changes of heart valves after rheumatic fever infection.

  4. Pulmonary heart disease:Cardiovascular disease caused by increased pulmonary circulation resistance, pulmonary hypertension due to pulmonary, chest wall, or pulmonary artery vascular lesions, leading to right heart hypertrophy and enlargement, and even right heart failure.

  5. Myocardial disease:Myocardial changes due to metabolic or hormonal abnormalities, sometimes alcoholism, and drugs can also cause myocardial changes.

  6. Cardiac tumors:Emboli caused by the surface fragments or thrombosis of cardiac tumors. It may be related to tumor products, tumor necrosis, or immune response.

  7. Cardiovascular diseases caused by other diseases:Including vascular lesions caused by hypertension and other immune dysfunction.

  8. Factors of external influence:Pulmonary hypertension caused by chronic low oxygen hypotension, and heart disease caused by infection.

 

2. What complications can complications of pregnancy with heart disease lead to

  Atrial septal defect, ventricular septal defect, and patent ductus arteriosus are prone to pneumonia, easy to develop heart failure, and tetralogy of Fallot often can be complicated with cerebral thrombosis and brain abscess. Hypertensive heart disease: During the compensatory period of heart function, patients may have no obvious自觉 symptoms, and during the decompensatory period of heart function, symptoms of left heart failure gradually appear, initially only palpitations, dyspnea, and cough during fatigue, overeating, or excessive talking, and then symptoms gradually worsen, the above symptoms present in paroxysmal attacks, mainly manifested as nocturnal paroxysmal dyspnea with blood in sputum, and severe cases may develop acute pulmonary edema.

3. What are the typical symptoms of complications of pregnancy with heart disease

  First, congenital heart disease:

  Mild cases have no symptoms, and they are found during physical examination, such as squatting sign, clubbing, pulmonary hypertension, and growth and development delay in older children. Children have pale complexion, shortness of breath, difficulty breathing, and tachycardia, with marked cyanosis in the nose tip, lips, and nail beds. Children often have abnormal development, manifested as thinness, malnutrition, and growth delay. Some have chest pain and syncope. Some have abnormal sweating.

  Second, coronary heart disease:

  Symptoms include a crushing pain in the middle of the chest, which can spread to the neck, jaw, arm, lower back, and stomach. Other possible symptoms include dizziness, shortness of breath, sweating, chills, nausea, and fainting. Severe patients may die of heart failure.

  Third, rheumatic heart disease:

  In the early stage of the disease, there are often no obvious symptoms, and in the later stage, it is manifested as palpitations, shortness of breath, fatigue, cough, limb edema, expectoration of pink frothy sputum, and eventually death due to heart failure.

 

4. How to prevent complications of pregnancy with heart disease

  Try not to sit in front of the computer or in places with strong magnetic fields such as microwave ovens for too long in the early stages of pregnancy (before 3 months).

  When the following phenomena occur in life, it is recommended to have a heart examination to detect heart disease early and take effective preventive and treatment measures:

  Heart disease can be suspected when the following symptoms appear:

  1. Uncomfortable symptoms such as palpitations, fatigue, and shortness of breath during physical activities or in public places, or the feeling of difficulty breathing; sudden chest pain or chest compression during fatigue or tension; left chest pain accompanied by sweating, or pain radiating to the shoulder, arm, and neck; children's activity ability is worse than that of peers, feeling palpitations, shortness of breath, fatigue, and cyanosis of the lips during activity;

  2. Pulse rate is too fast, too slow, short, or irregular; lower limb edema; the tips of fingers or toes become enlarged and deformed; the face, lips, and nails appear cyanotic or dark red and other abnormal colors;

  3. Suddenly waking up from deep sleep or having a bad dream, feeling palpitations, chest tightness, and difficulty breathing, which improves after sitting up for a while; feeling short of breath when sleeping with a low pillow at night, and needing to sleep with a high pillow; feeling palpitations, chest tightness, or chest pain after a hearty meal, cold, smoking, or watching a suspenseful movie or TV show; suddenly experiencing a spell of palpitations, dizziness, and darkening of vision, with a sensation of fainting;

  4. After a cold, even slight exertion may cause palpitations and fatigue, or walking a little faster may feel short of breath; during pregnancy, palpitations, dizziness, shortness of breath, or edema may occur; at rest, there may be an abnormal sound in the heartbeat, or a palpable tremor may be felt when the palm is pressed on the chest wall over the heart area.

 

5. What laboratory tests need to be done for gestational complications

  1. Holter monitoring:Also known as long-term ECG, it can provide information on the dynamic electrocardiogram of the examinee throughout the day. It effectively supplements the shortcomings of conventional ECG, and not only can obtain electrocardiogram data for 24 hours or even 48 hours continuously, but also, combined with the patient's activity diary, can clarify the relationship between the patient's symptoms, activity status, and medication with the changes in the electrocardiogram.

  2. ECG exercise stress test:It is a diagnostic method for early coronary artery disease, although it has a certain proportion of false negatives and false positives when compared with coronary angiography results, it is still widely recognized as an important clinical examination method due to its convenience, non-invasiveness, and safety. Among them, the flat treadmill test is currently the most widely used exercise stress test method.

  3. Echocardiography examination:Observes the shape and structure of the heart and large vessels, as well as the pulsation state, to understand the regularity of atrioventricular contraction and relaxation, and the closing and opening of valves, providing important reference materials for clinical use.

  4. X-ray examination:On the heart X-ray film, the transverse diameter, chest-to-heart ratio, and heart area can be measured more accurately.

  5. CT examination:Checks heart shape, heart function, myocardial tissue, and quantitative and qualitative analysis of myocardial perfusion to determine the presence of coronary artery disease.

  6. Magnetic resonance imaging:Indicates large vessel and myocardial infarction locations; PET can show early myocardial metabolic abnormalities, but it is expensive, and those who can afford it can choose it.

  7. Radionuclide cardiac imaging:Including myocardial imaging at rest and dynamic imaging combined with exercise tests. There is a 'cold spot' imaging method using 201Tl or 99mTc-MIBI to make normal myocardium visible while the ischemic area is not, and a 'hot spot' imaging method using 99mTc phosphates to make recently necrotic myocardium visible while normal myocardium is not, for the localization of myocardial infarction and early diagnosis of coronary artery disease. Newer imaging methods include single-photon emission computed tomography.

 

6. Dietary recommendations for patients with gestational complications

  The dietary treatment for gestational complications is as follows:

  1. Stir-fried spinach with eggs

  Ingredients: 100 grams of spinach, 2 eggs, scallions, salt, and vegetable oil.

  Method:

  (1) Pick and wash the old leaves of spinach, cut into 3 cm long pieces, blanch in boiling water for a while, remove and drain the water.

  (2) Beat the eggs, fry them in the oil pot until cooked and then transfer to a plate.

  (3) Heat the oil in the pot, add scallion slices to sauté, then pour in spinach and stir-fry with salt for a few turns.

  (4) Then pour in the fried eggs, stir-fry evenly and it's done.

  2, Dried Shrimp and Spinach Porridge

  Wash rice, soak dried shrimp, wash spinach, blanch and cut into segments. Boil an appropriate amount of water in a pot, add rice and dried shrimp together, and cook into porridge. Add spinach when the porridge is cooked, and cook briefly.

  3, Ginger Juice Spinach

  Wash spinach, remove roots and yellow leaves, and blanch in boiling water, then cool in cold water, drain, cut into segments; peel the ginger, wash it, slice it into thin strips, and then chop it into pieces, add it to the spinach. Then mix salt, soy sauce, vinegar, sesame oil, and spinach together and mix well before eating.

  4, Chinese Wolfberry and Pork Stomach Soup

  30 grams of fish maw, 10 grams of Chinese wolfberry, 100 grams of pork stomach, and appropriate seasonings. Preparation: Clean the pork stomach, slice it, soak the fish maw, and put it in the pot with the wolfberry, add an appropriate amount of water, and boil until the two are cooked. Usage: Drink the soup and eat the fish maw and wolfberry, and it can be seasoned with condiments.

  5, Cruciian Carp and Glutinous Rice Porridge

  1 live crucian carp (about 500 grams), 20-30 grams of ramie root, 50 grams of glutinous rice, and appropriate amounts of scallion, ginger oil, salt. Preparation: Remove the scales and internal organs of the crucian carp, wash and slice, then boil in water. Take 200 grams of water and ramie root, boil to 100 grams, remove the residue and keep the juice, add it to the crucian carp soup, and add glutinous rice, scallion, ginger, oil, and salt as appropriate, and cook into a thin porridge. Usage: Eat hot in the morning and evening, 3-5 days as a course. Effect: Relieve pregnancy, stop bleeding, and reduce swelling. Suitable for pregnancy restlessness, vaginal bleeding, and pregnancy edema.

  6, Eucheuma and Egg Soup

  10 grams of Eucheuma and 1 egg, with salt to taste. Preparation: Dissolve the Eucheuma in 1 bowl of water, mix the egg well and add it to the Eucheuma water, then boil it into a flower. Usage: Take 1-2 times a day, seasoned with salt.

 

7. Conventional Western Medicine Treatment for Complications of Pregnancy

  The treatment options for different types and conditions of heart disease vary. Drug treatment is the foundation, and many diseases can be effectively treated with medication. There are also interventional treatments, the most common of which is the coronary artery stent placement for coronary heart disease, and congenital heart disease can also be treated with interventional methods. The most common surgical treatment is congenital heart disease. Severe coronary heart disease may require bypass surgery. Some more serious heart diseases, such as late-stage diseases, may require surgical treatment or heart transplantation.

 

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