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thanks to developments in surgical techniques and the advancements in medical care that have occured over the last 30 years, pregnancies in women with congenital heart diseases occur more frequently now than in the past. this is due to the fact that pror to these advancements, these women rarely survived to become fecumd. the most common congenital lesions suffered by this population are: ventricular septal defect (VSD), atrial septal defect (ASD), and aortic stenosis (AS), mostly due to a bicuspid aortic valve.
during pregnancy, maternal cardiac function is influened by gestational hormones and as a result cardiac output increases concomitantly to the decrease in arterial blood pressure. in addition the fetal ferrum consumption may cause maternal anemia that result in a further increase in the maternal heart rate. VSD, ASD, and patent ductus arteriosus (PDA) are related to a left-to-right shunt and to pulmonary hypertension, which is considered a serious risk factor.
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