Cardiovascular Complications of Pregnancy Maria Carolina Gongora and Nanette K. Wenger

Abstract: Pregnancy causes significant metabolic and hemodynamic changes in a woman’s
physiology to allow for fetal growth. The inability to adapt to these changes might result in
the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or
eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these
complications are not limited to the pregnancy period and may leave permanent vascular and
metabolic damage. There is in addition, a direct association between these disorders and
increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart
disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this
association, women who present with these complications of pregnancy do not receive
adequate postpartum follow up and counseling regarding their increased risk of future CVD.
The postpartum period in these women represents a unique opportunity to intervene with
lifestyle modifications designed to reduce the development of premature cardiovascular
complications. In some cases it allows early diagnosis and treatment of chronic hypertension
or diabetes mellitus. The awareness of this relationship is growing in the medical
community, especially among obstetricians and primary care physicians, who play a pivotal
role in detecting these complications and assuring appropriate follow up.

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