Next Article in Journal
Rehabilitation Program Combined with Local Vibroacoustics Improves Psychophysiological Conditions in Patients with ACL Reconstruction
Previous Article in Journal
Association of Kidney Function Tests with a Cardio-Ankle Vascular Index in Community-Dwelling Individuals with a Normal or Mildly Decreased Estimated Glomerular Filtration Rate
Open AccessReview

Cardiovascular Outcomes in Advanced Maternal Age Delivering Women. Clinical Review and Medico-Legal Issues

1
Department of Cardiology, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy
2
Department of Obstetrics and Gynecology, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy
3
Section of Legal Medicine, Università Politecnica delle Marche, 60120 Ancona, Italy
4
Department of Anesthesia and Analgesia, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy
5
Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University, 00161 Rome, Italy
*
Author to whom correspondence should be addressed.
The authors equally contribute to the paper.
Medicina 2019, 55(10), 658; https://doi.org/10.3390/medicina55100658
Received: 29 May 2019 / Revised: 23 September 2019 / Accepted: 24 September 2019 / Published: 29 September 2019
(This article belongs to the Section Emergency Medicine)
Background and objecives: Adverse cardiovascular outcomes during pregnancy have increased over the past few decades, with increased numbers of women delivering later in their reproductive life. Other factors include higher rates of female obesity, diabetes, hypertension, cardiovascular diseases and assisted reproductive technology, which has extended fertility. Those at risk require extensive prenatal maternal screening, constant pregnancy supervising, monitoring during labor, delivery and puerperium and careful anesthetic evaluation during delivery. Materials and Methods: The present review reports the relevant information available on cardiovascular outcomes in advanced maternal age delivering women and related medico-legal issues. The search was performed on Pubmed, Cochrane, Semantic Scholar, Medline and Embase databases, accessed by Ovid, including among others the terms “cardiomyopathy”, “ischaemic heart disease”, “arrhythmias”, “hypertension”, “peripartum period”, “diabetes”, “advanced maternal age” “anesthesia”, “maternal morbidity and mortality” and “litigation”. Results: To the extent that underestimating risk factors for peripartum cardiomyopathy (PPCM) can adversely impact maternal and fetal outcomes, the legal implications of misdiagnosis or mismanagement can result in high compensatory damages. Substantial indemnity payments drive up costs of insurance coverage. Conclusions: Multidisciplinary approaches are necessary from obstetricians, cardiologists, anesthesiologists and perinatologists for pregnancy monitoring and delivery outcomes. View Full-Text
Keywords: pregnancy; advanced maternal age; cardiovascular outcomes; peripartum cardiomyopathies (PPCM); hypertension; diabetes; arrhythmias pregnancy; advanced maternal age; cardiovascular outcomes; peripartum cardiomyopathies (PPCM); hypertension; diabetes; arrhythmias
MDPI and ACS Style

De Viti, D.; Malvasi, A.; Busardò, F.; Beck, R.; Zaami, S.; Marinelli, E. Cardiovascular Outcomes in Advanced Maternal Age Delivering Women. Clinical Review and Medico-Legal Issues. Medicina 2019, 55, 658.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop