Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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146 Maternal Intensive Care in Belgium KCE Reports 94 • Mild to moderate malformations of pulmonary or tricuspid valve • NYHA class I and II² • Every disorder labelled as low-risk by a cardiologist but not specified as a disorder requiring a level of intermediate care • Bicuspid aortic valve (no stenosis) • Diagnostic cardiac catheterisation • Transoesophageal echocardiography • Balloon valvuloplasty/balloon dilatation of coarctation of aorta • Coarctation of the aorta (uncorrected, uncomplicated and complicated) • Artificial valve • Implantation of cardiac pacemakers/defibrillators • Cardiac surgical operations • Implantation of occlusive devices, eg ductal occluders, septal occluders • PTCA/PCI/stent implantation • Acquired valvular heart diseases • Mitral valve prolapse with valvular regurgitation or severe valve thickening • Homograft or bioprosthetic valves • Aortic or mitral stenosis (particulary NYHA functional class III and IV) • Severe pulmonic stenosis • Surgically constructed systemic or pulmonary conduits • Left ventricular dysfunction (moderate to severe) • Previous left ventricular dysfunction now resolved (such as peripartum cardiomyopathy) • Previous myocardial infarction • Pulmonary hypertension • Marfan syndrome with aortic root or valve involvement • Cardiomyopathy • Eisenmenger’s syndrome² • Hart transplant • Cardio-vascular infections • Every disorder labelled as high-risk by a cardiologist (e.g. cardiac arrhythmia) but not specified as a disorder requiring a level of standard care ppp Horstkotte, D. et al (2004). Guidelines on prevention, diagnosis and treatment of infective endocarditis. The task force on infective endocarditis of the European Society of Cardiology. September, 5 th , 2007 from Cebam, National guideline clearinghouse : www.guideline.gov qqq Ramsdale, D. & Turner-Stokes, L. (2004). Prophylaxis and treatment of infective endocarditis in adults: concise guidelines. September, 5 th , 2007 from Cebam, Royal college of physicians (UK): www.rcplondon.ac.uk. rrr Arafah, J. & McCurtry, S. (2006). Cardiac disease in pregnancy. Crit. Care Nurs Q, 29, 32-52. sss Finnish Medical Society Duodecim (2006). Systemic diseases in pregnancy. Retrieved Mai 15, 2007 from Cebam, National guideline clearinghouse : www.guideline.gov.
KCE Reports 94 Maternal Intensive Care in Belgium 147 Thrombotic disorders • Thrombophilia needing no thromboprophylaxis ttt • Every disorder labelled as low-risk by a haematologist but not specified as a disorder requiring a level of intermediate care Infectious disorders (independent from gestational age) • Every disorder labelled as low-risk by an infectiologist but not specified as a disorder requiring a level of intermediate care • No severe infection or sepsis Thrombotic disorders • Any form of thrombophilia which requires thromboprophylaxis for maternal reasons Infectious disorders (independent from gestational age) Thrombotic disorders² • Antiphospholipid syndrome • Any form of thrombophilia which requires thromboprophylaxis uuu • History of (deep vein) thrombosis or pulmonary embolism associated with ATIII-/ protein C-/ protein S-deficiency ² • Every disorder labelled as high-risk by a haematologist but not specified as a disorder requiring a level of standard care Infectious disorders (independent from gestational age) Care for maternal reasons: • Active TBC • Malaria • Gonorrhoea • Varicella • Herpes • Sepsis Care for foetal reasons: • Toxoplasmosis (with suspected or confirmed fetal anomalies) • CMV (with maternal clinical symptoms and or fetal anomalies) • Epstein Bahr Virus • Syphilis • HIV • Parvovirus • Listeria (with clinical symptoms) • Rubella • Every infection labelled as high-risk by a infectiologist but not specified as a disorder requiring a level of ttt RCOG. (2004). Thromboprophylaxis during pregnancy, labour and after vaginal delivery, guideline nr 37. Retrieved on June 20, 2007 from cebam, http://www.rcog.org.uk/resources/Public/pdf/Thromboprophylaxis_no037.pdf. uuu RCOG. (2004). Thromboprophylaxis during pregnancy, labour and after vaginal delivery, guideline nr 37. Retrieved on June 20, 2007 from cebam, http://www.rcog.org.uk/resources/Public/pdf/Thromboprophylaxis_no037.pdf.
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