Monday December 17, 2018

ESC Directs Women With Heart Disease To Give Before 40 Weeks

While women with heart disease can have a healthy pregnancy, they should be aware of a higher risk of obstetric complications.

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Pregnant women with heart disease should give birth at no later than 40 weeks gestation, beyond that harm can be caused to the mother, new guidelines by the European Society of Cardiology (ESC) recommends.

Besides pre-pregnancy risk assessment and counselling, a delivery plan should be devised at 20-30 weeks, specifying vaginal or caesarean delivery, whether an epidural or forceps will be used, and the duration of hospital stay after delivery, the guidelines said.

“Pregnancy is a risky period for women with heart disease because it puts additional stress on the heart, so the guidelines advise inducing labour or a caesarean section at 40 weeks,” said Jolien Roos-Hesselink, Professor at the Erasmus University in Rotterdam, Netherlands.

 

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Since carrying more than one baby puts more stress on the heart, women with heart disease undergoing IVF are strongly advised to transfer a single embryo.
Pixabay

 

“Beyond 40 weeks, pregnancy has no added benefit for the baby and may even have negative effects,” Roos-Hesselink added.

Heart disease is the main reason women die during pregnancy in western countries, because they have a 100-fold greater risk of death or heart failure than their healthy peers.

An estimated 18-30 per cent of the offsprings have complications and up to 4 per cent of neonates die.

The new guidelines, published in the European Heart Journal, also recommended against in vitro fertilisation (IVF), contraception, and termination of pregnancy for women with heart disease.

It is because IVF often uses high doses of hormones, which increases the risk of thrombosis and heart failure, so women with heart diseases need a cardiologist’s confirmation.

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The new guidelines, published in the European Heart Journal, also recommended against in vitro fertilisation (IVF). Pixabay

“Since carrying more than one baby puts more stress on the heart, women with heart disease undergoing IVF are strongly advised to transfer a single embryo,” the guidelines said.

Also Read: Stress During Pregnancy Increases Risk of Mood Disorder in Daughters

While women with heart disease can have a healthy pregnancy, they should be aware of a higher risk of obstetric complications including premature labour, pre-eclampsia, and post-partum bleeding.

Moreover, girls with congenital heart disease should take advice before using contraceptives because some methods are contraindicated in patients with certain types of heart disease, the guidelines noted. (IANS)

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The Risk of FGM Hangs Above British Schoolgirls During Holiday Break

Ending FGM requires multiple entry points (and) enabling families and communities to be proactive in ending the practice of FGM is ultimately the most effective channel

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A badge reads "The power of labor against FGM" is seen on a volunteer during a conference on International Day of Zero Tolerance for Female Genital Mutilation (FGM) in Cairo, Egypt, Feb. 6, 2018. (VOA)

As many families prepare to holiday abroad during the festive season, British charities on Monday warned that girls taken overseas could be at risk of female genital mutilation(FGM)

Known as FGM, female genital mutilation is a ritual that usually involves the partial or total removal of the external genitalia, including the clitoris. Some girls bleed to death or die from infections.

Cutting affects an estimated 200 million girls worldwide and is a rite of passage in many societies, often with the aim of promoting chastity, with the highest prevalence in Africa and parts of the Middle East.

An estimated 137,000 women and girls in England and Wales have undergone FGM. Many cases go unnoticed because they had happened at a young age and abroad, campaigners say. Campaigners say teachers should look out for warning signs, such as when a child is taken abroad for a long time to a country where there is a high prevalence of female genital mutilation.

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– A doctor checks her phone as she poses for a photograph in Mumbai, India, June 8, 2016. The 50-year-old woman defends what is widely considered female genital mutilation within her small, prosperous Dawoodi Bohra community in India. VOA

“The best way of preventing the practice is by working with girls and their families … and training professionals like teachers and social workers to spot girls at risk of FGM,” said Leethen Bartholomew, head of Britain’s National FGM Center.

Some warning signs that a girl might have been cut include difficulty walking or sitting down, spending a long time in the toilet or becoming withdrawn, said the Center, run by children’s charity Barnardo’s and the Local Government Association.

FGM has been a criminal offense in Britain since 1985. Legislation in 2003 made it illegal for British citizens to carry out or procure female genital mutilation abroad, even in countries where it is legal.

In 2015, it became mandatory for health professionals, social workers and teachers in Britain to report known cases of FGM to police.

FGM
FILE – A T-shirt warns against female genital mutilation. Its wearer attends an event, discouraging harmful practices such as FGM, at a girls high school in Imbirikani, Kenya, April 21, 2016. VOA

The practice mostly affects immigrant communities from various countries including Somalia, Sierra Leone, Eritrea, Sudan, Nigeria and Egypt.

British-based charity Forward, which supports FGM survivors from African communities, said though teachers have a crucial role to play, they should not stigmatize certain communities.

“While teachers need to be alert at all times about safeguarding children in their care, we also need to ensure that some communities are not unduly targeted and stigmatized,” said Naana Otoo-Oyortey, executive director of FORWARD.

Also Read: Female Genital Mutilation Unconstitutional: Michigan Judge

“Ending FGM requires multiple entry points (and) enabling families and communities to be proactive in ending the practice of female genital mutilation is ultimately the most effective channel,” she said in emailed comments to the Thomson Reuters Foundation.

Britain in November pledged $63 million to combat female genital mutilation in Africa. (VOA)