Cardiovascular Diseases during Pregnancy

Pregnancy increases the risk of new-onset SVT. This risk is more in pregnant patients with Wolff-Parkinson-White syndrome. In the absence of structural heart disease, AF and atrial flutter are rare during pregnancy. Non-sustained ventricular arrhythmias takes place in up to 50% of pregnant women, but the clinical risk of sustained ventricular arrhythmia in the absence of structural heart disease is low.

Most antiarrhythmic drugs are divided as category C drugs while pregnancy by the United States Food and Drug Administration (FDA) .Therefore, drug therapy should be used only in patients who have life-threatening arrhythmias or debilitating symptoms. Most β-blockers are classified as category C drugs by the FDA; however, atenolol is classified as a category D drug because it has been implicated in intrauterine growth retardation, and sotalol, pindolol, and acebutolol are classified as category B drugs. The other class C drugs include digoxin, adenosine and heparin, whereas lidocaine and enoxaparin are class B drugs. Enoxaparin is safe for the fetus, but some formulations contain the preservative benzyl alcohol, which can be harmful. Amiodarone is taken as category D drug, and warfarin (category X) should not be used at all during pregnancy because of its teratogenicity.

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