Structural changes have been detected by transthoracic
echocardiography studies (Robson et
al, 1989). Echocardiography during the second
and third trimester should show hyperdynamic
ventricular function in response to the haemodynamic
changes. Even mild ventricular impairment
should be taken seriously and the cause investigated
promptly by a maternal cardiologist.
Pregnancy is also a hypercoagulable state, and
carries a higher risk of thrombosis. This is particularly
relevant in women with arrhythmias or
prosthetic heart valves and input from haematology
services to ensure adequate anticoagulation