妊娠・出産
Family Planning and Pregnancy: US and Europe Perspectives 1:05:26-1:07:51 Q: Do you have any women with Marfan who have also received a mechanical heart valve and are on blood thinners carrying a baby to term? You want to take that? Julie …
Family Planning and Pregnancy: US and Europe Perspectives 1:02:51-1:03:32 In summary most women with all connective tissue disorders have favorable outcomes in pregnancy, however, the diagnosis prior to pregnancy, proper surveillance, and …
Family Planning and Pregnancy: US and Europe Perspectives 1:01:15-1:02:49 Now another important thing is that postpartum you have multiple mom and baby so we're going to shift our attention to include the well-being of the child and their …
Family Planning and Pregnancy: US and Europe Perspectives 59:11-1:01:14 But one, one area of risk that has been focused upon is breastfeeding, so oxytocin and is a chemical released endogenously in each person that stimulates both labor an…
Family Planning and Pregnancy: US and Europe Perspectives 57:41-59:10 Overall the majority of aortic complications occur in the third trimester but it's also the postpartum period and that's something we haven't discussed at all yet, so wh…
Family Planning and Pregnancy: US and Europe Perspectives 56:04-57:40 Now cervical instability is another, another spiral manifestation that has an increased risk in Loeys-Dietz syndrome. This can be assessed with an x-ray of the cervical …
Family Planning and Pregnancy: US and Europe Perspectives 54:59-56:03 The spinal anatomy, which differs based on the genetic aortopathy that a person might have, can impact the anesthetic choice and these are a few examples: dural ectasia …
53:49-54:58 I wanted to just try to illustrate and, and simplify what we're talking about between these different types of anesthesia, so general anesthesia would generally require intubation and mechanical ventilation but with regional an…
Family Planning and Pregnancy: US and Europe Perspectives 51:40-53:48 As introduced my name is Mary Shepard and I'm happy to be here to talk with you about delivery and postpartum care. I try to build this chart as a nice summary basically…
Family Planning and Pregnancy: US and Europe Perspectives 50:03-50:59 So I came to the to my final recommendations and as we have seen that pregnancy in patients with aortic disease should be managed by a multidisciplinary team and an expe…
49:01-50:02 So to conclude I would also make some, some discuss some aspects of pregnancy in patients with Loeys-Dietz syndrome although the data is much scarcer in this group and of course we know that the risk of aortic dissection during…
Family Planning and Pregnancy: US and Europe Perspectives 47:35-49:00 Of course, the question of the timing has been evaluated a little bit in more detail in this recently published meta-analysis and in this analysis they analyzed 386 pati…
Family Planning and Pregnancy: US and Europe Perspectives 44:57-47:34 So I will continue with the final part of my presentation and discuss surgery during pregnancy and of course this is something we want to avoid but unfortunately still i…
Family Planning and Pregnancy: US and Europe Perspectives 43:50-44:56 So all our patients with aortic disease should be seen on a regular basis throughout the pregnancy for evaluating the aortic root and echocardiography is the preferred d…
Family Planning and Pregnancy: US and Europe Perspectives 42:24-43:49 So does it pay off? Well, there are a few studies who actually evaluated the safety and the course of pregnancy in patients who are treated according to the current guid…
41:21-42:23 So one of the previous speaker already discussed the use of the prophetic use of beta blocks in pregnancy. Well, some studies actually observed a reduced rate of progression of aortic dilatation, so according to the European gu…
Family Planning and Pregnancy: US and Europe Perspectives 39:56-41:20 So patients with aortic pathology should be overseen in specialized centers and supervised by both cardiologists and obstetricians who are actually aware of the potentia…
Family Planning and Pregnancy: US and Europe Perspectives 38:42-39:55 So there is an increased risk for aortic dissection in pregnancy, which is the result of both hemodynamic, hormonal but also from thromboembolic changes and actually pre…
Family Planning and Pregnancy: US and Europe Perspectives 37:12-38:41 I will continue this webinar with the next topic, "the follow-up during pregnancy," so in the coming minutes I will discuss when we should see our patients and who actua…
Family Planning and Pregnancy: US and Europe Perspectives 34:58-36:47 And then to end this presentation I just want to mention that every woman wanting to become pregnant should have a cardiac ultrasound done prior to pregnancy to look at …
Family Planning and Pregnancy: US and Europe Perspectives 34:13-34:57 So very briefly some prospective data and I'm going to skip this slide because I know that Martijn is going to address this one but I just want to mention with you that …
Family Planning and Pregnancy: US and Europe Perspectives 32:58-34:12 So even after aortic root replacement because if you recommend replacement before pregnancy you should be aware that you are still not in an absolutely safe zone, so the…
Family Planning and Pregnancy: US and Europe Perspectives 29:49-32:57 So how can we reduce the risk? As I mentioned knowing the diagnosis is really, really paramount. Pre-pregnancy counseling as Melissa has nicely explained. Follow-up duri…
Family Planning and Pregnancy: US and Europe Perspectives 28:52-29:49 So how can this risk be estimated? We use risk estimations and this is the most widely used risk estimation. The, WHO risk estimation where you have categories going fro…
Family Planning and Pregnancy: US and Europe Perspectives 26:21-28:53 So risk factors in the setting of, of, of Marfan disease and related heritable thoracic aortic diseases diagnosis of the aortopathy is really crucial. Most women in seri…
Family Planning and Pregnancy: US and Europe Perspectives 22:52-26:21 I will be addressing firstly what is the risk that we are talking about, how can we estimate the risk, how can we reduce the risk and I'll be addressing prophylactic sur…
Family Planning and Pregnancy: US and Europe Perspectives 21:15-21:49 So the summary from this first part is really just saying get information about your body and the risks and imaging and consultation prior to even thinking about pregnan…
Family Planning and Pregnancy: US and Europe Perspectives 18:05-21:13 The procedure of IVF is complex, so just to sort of walk you through what this entails. First, the first the, the mother needs to have hormonal medications to induce ovu…
Family Planning and Pregnancy: US and Europe Perspectives 16:42-18:03 So talking just about pre-implantation genetic ??? testing on the embryo. It's usually going to be made in a dish and then it's day five or six, you can take one cell fr…
Family Planning and Pregnancy: US and Europe Perspectives 16:01-16:39 So the decision to become a parent again is really a personal decision and then how you achieve this goal is very individualized based on your medical risks, your morals…
