p.4 抽出テキスト

........................................................................................................................................................ 9.7.1 Sinus node dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3204 9.7.2 Atrioventricular block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3204 9.8 Interventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3204 9.8.1 Electrical cardioversion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3204 9.8.2 Catheter ablation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3204 9.8.3 Implantable cardioverter-defibrillator and pacing. . . . . . 3204 9.9 Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3206 10. Hypertensive disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3207 10.1 Diagnosis and risk assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3207 10.1.1 Blood pressure measurement. . . . . . . . . . . . . . . . . . . . . . . 3207 10.1.2 Laboratory tests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3207 10.2 Definition and classification of hypertension in pregnancy . . . 3207 10.3 Prevention of hypertension and pre-eclampsia . . . . . . . . . . . . . 3207 10.4 Management of hypertension in pregnancy . . . . . . . . . . . . . . . . . 3208 10.4.1 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3208 10.4.2 Non-pharmacological management . . . . . . . . . . . . . . . . . 3208 10.4.3 Pharmacological management. . . . . . . . . . . . . . . . . . . . . . . 3208 10.5 Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3208 10.6 Prognosis after pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3209 10.6.1 Blood pressure post-partum. . . . . . . . . . . . . . . . . . . . . . . . 3209 10.6.2 Hypertension and lactation . . . . . . . . . . . . . . . . . . . . . . . . . 3209 10.6.3 Risk of recurrence of hypertensive disorders in a subsequent pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3209 10.6.4 Long-term cardiovascular consequences of gestational hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3209 10.6.5 Fertility treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3209 10.7 Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3209 11. Venous thrombo-embolic disease during pregnancy and the puerperium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3210

11.1 Epidemiology and maternal risk. . . . . . . . . . . . . . . . . . . . . . . . . . . . 3210 11.2 Risk factors for pregnancy-related venous thrombo-embolism and risk stratification. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3210 11.3 Prevention of venous thrombo-embolism. . . . . . . . . . . . . . . . . . 3210 11.4 Management of acute venous thrombo-embolism . . . . . . . . . . 3210 11.4.1 Pulmonary embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3210 11.4.2 Acute deep vein thrombosis . . . . . . . . . . . . . . . . . . . . . . . . 3211 11.5 Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3211 11.5.1 Management of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3211 12. Drugs during pregnancy and breastfeeding . . . . . . . . . . . . . . . . . . . . . 3212 12.1 General principles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3212 12.1.1 Pharmacokinetics in pregnancy. . . . . . . . . . . . . . . . . . . . . . 3212 12.1.2 Drug classes in pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . 3213 12.2 US Food and Drug Administration classification . . . . . . . . . . . . 3214 12.3 Internet databases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3214 12.4 Pharmaceutical industry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3214 12.5 Recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3214 13. Gaps in the evidence. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3231 14. Key messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3231 15. ‘What to do’ and ‘what not to do’ messages from the Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3233 16. Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3236 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3237

List of tables

Table 1. Classes of recommendation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3170 Table 2. Level of evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3171 Table 3. Modified World Health Organization classification of maternal cardiovascular risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3175 Table 4. Predictors of maternal and neonatal events. . . . . . . . . . . . . . . . 3176 Table 5. Aortic diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3188 Table 6. Recommended surveillance levels at time of delivery in women with arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3205 Table 7. Drugs and safety data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3215

Abbreviations and acronyms

ABPM Ambulatory blood pressure monitoring ACE Angiotensin-converting enzyme ACE-I Angiotensin-converting enzyme inhibitor ACR Albumin:creatinine ratio ACS Acute coronary syndromes AF Atrial fibrillation AHF Acute heart failure AMI Acute myocardial infarction aPTT Activated partial thromboplastin time ARB Angiotensin receptor blocker ARNI Angiotensin receptor neprilysin inhibitor AS Aortic stenosis ASD Atrial septal defect ASI Aortic size index AT Atrial tachycardia AUC Area under the curve AV Atrioventricular BMI Body mass index BP Blood pressure BSA Body surface area CAD Coronary artery disease CARPREG CARdiac disease in PREGnancy CCB Calcium channel blocker CI Confidence interval CO Cardiac output CoA Coarctation of the aorta CPG Committee for Practice Guidelines CT Computed tomography CVD Cardiovascular disease DBP Diastolic blood pressure DCM Dilated cardiomyopathy Downloaded from academic.oup.com/eurheartj/article/39/34/3165/5078465 by guest on 07 October 2026