Kofinas Perinatal Providing Care to the Unborn ® HEMODYNAMIC CHANGES AND CARDIAC FUNCTION DURING THE COURSE OF NORMAL PREGNANCY AND THE PEURPERIUM

Alexander D. Kofinas, MD Director, Kofinas Perinatal Associate Professor, Clinical Obstetrics and Gynecology Cornell University, College of Medicine Introduction Pregnancy is associated with substantial physiologic changes that require adaptation of the cardiovascular system. Maternal heart disease can interfere with this process and, therefore, may have an important effect on both the mother and fetus. The increased circulatory burden of pregnancy can unmask previously unrecognized heart disorders and rapidly worsen heart disease toward a potentially lethal situation. Recognition and management of cardiac illness in pregnancy can be difficult at times. The absence of well-defined treatment guidelines and only scanty literature in the field represent further burdens for the practicing physician. A comprehensive understanding of cardiovascular adaptation during pregnancy, labor, and the puerperium is essential for the management of pregnant patients with cardiovascular disorders.