Abstract
For several days after delivery, the maternal circulatory dynamics change very dramatically. The venous return increases immediately after child and placental expulsion due to rapid uterine contractions, while bleeding and vascular permeability are increased due to the delivery. This balance determines the circulating plasma volume right after delivery. For several days, diuresis decreases, vascular permeability becomes normal, and fluid stored in the third space returns to the blood vessels. Therefore, the circulating plasma volume in many cases reaches a peak several days after delivery. Immediately after delivery, there is a risk of severe obstetric bleeding, and thromboembolism can easily develop due to accelerated blood coagulation. Since the maternal death often occur within 1 week after delivery, careful attention during this period is required especially for women with severe heart disease.
Peripartum cardiocirculatory changes are considered to persist up to 3–6 months after delivery. There are almost no reports on the effects of the risks of child-rearing, including breast-feeding, on mothers with cardiovascular disease. Several studies suggested that hormones related to lactation, such as oxytocin and prolactin, might be possible pathogenetic factors of postpartum aortic dissection and peripartum cardiomyopathy. In addition, it was also reported that the risk of a cardiac event would be highest in the postpartum period in women with long QT syndrome.
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Aoki-Kamiya, C. (2019). Postpartum Management. In: Ikeda, T., Aoki-Kamiya, C. (eds) Maternal and Fetal Cardiovascular Disease. Springer, Singapore. https://doi.org/10.1007/978-981-10-1993-7_4
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DOI: https://doi.org/10.1007/978-981-10-1993-7_4
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