Is it Possible to Bring 4 Pregnancies to Term with Obstructive HCM without Maternal or Fetal Complications? (A Case Report and Literature Review)
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Obstructive hypertrophic cardiomyopathy (HCM) during pregnancy is associated with significant maternal and perinatal morbidity. Physiological changes during pregnancy can induce complications: sudden death, heart failure and arrhythmia involving the maternal and fetal prognosis. Women with HCM generally tolerate pregnancy well. The risk is however higher in women who are symptomatic before pregnancy or in those with severe left ventricular outflow tract obstruction. The incidence of arrhythmias does not appear to be increased during pregnancy and maternal mortality is low. Prior to conception, women with HCM should have a risk assessment as well as genetic counseling. A vaginal delivery with regional anesthesia is usually appropriate. Women should be managed by a specialist multidisciplinary team. We report the case of a 39-year-old patient with no known family history of HCM or any notion of sudden death in the family. G4P5 (the second pregnancy is twin). All 4 deliveries are completed and were vaginally without maternal or fetal complications. and who has a symptomatic obstructive HCM.
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