Cardiovascular diseases in pregnancy

All are true regarding physiological changes in cardiovascular system in pregnancy except ?

• Mean arterial pressure does not change

• cardiac output increases by 40%

• Uterine blood flow increases

• Pulmonary vascular resistance decreases

Which of the following is true regarding antepartum and intrapartum care of women with cardiovascular disorders ?

• Spinal blockade is the recommended anaesthetic

• Vaginal delivery is preferred

• Induction of labor at 37 weeks is preferred

• Invasive monitoring with pulmonary artery catheter is required

Which of the following is true regarding danger period of cardiac decompensation in pregnancy ?

• Immediate postpartum is danger period as cardiac output increases by almost 80%

• Pregnancy induced hypervolemia and maximum cardiac output make a pregnant women with heart disease more prone to complications at 28-32 weeks

• Peripheral vasodilation at 6-8 weeks can also lead to cardiac decompensation

• All of the above

A G1 with Severe mitral stenosis presents with acute dyspnea at 32 weeks in triage . Her blood pressure is 120/84 mm Hg , PR is 90 bpm and SpO2 on room air is 88%. She’s more comfortable in sitting position . What is the most probable diagnosis ?

• Congestive heart failure

• pulmonary edema

• pulmonary embolism

• None of the above

Absolute indications of Caesarean section in a patient with cardiac disease are all except

• Acute intractable heart failure

• Eisenmenger syndrome

• Aortic aneurysm

• None of these

All are true regarding peripartum cardiomyopathy except

• It can occur anytime between the final month of pregnancy and 5 months postpartum

• There is absence of identifiable cause of heart failure

• Non ischaemic cardiomyopathy

• Clinical symptoms are different from congestive heart failure

A woman with Aortic stenosis presents in active labor . Which of the following strategies are advisable ?

• Cut short second stage

• Generous fluid administration

• Epidural analgesia

• All of the above

All are true for management of cardiac arrest in pregnancy except ?

• CPR with 30 degrees left lateral tilt

• Manual left uterine displacement in supine position during CPR

• Defibrillation is not recommended

• Early intubation

Which of the following is not an indication of infective endocarditis prophylaxis ?

• VSD repaired with a synthetic patch without residual defect

• A patient with eisenmenger syndrome due to an atrial septal defect

• Patient with prosthetic mitral valve

• History of prior endocarditis

As per WHO , In which of the following conditions is pregnancy contraindicated ?

• Cyanotic heart disease

• Heart transplantation

• Pulmonary artery hypertension

• Ventricular dysfunction with left ventricular ejection fraction 35-%