{"id":39791,"date":"2023-05-24T12:06:01","date_gmt":"2023-05-24T10:06:01","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=39791"},"modified":"2023-05-24T12:06:02","modified_gmt":"2023-05-24T10:06:02","slug":"pribyva-zen-kterym-v-tehotenstvi-selhava-srdce","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=39791","title":{"rendered":"P\u0159ib\u00fdv\u00e1 \u017een, kter\u00fdm v\u00a0t\u011bhotenstv\u00ed selh\u00e1v\u00e1 srdce"},"content":{"rendered":"\n

Vy\u0161\u0161\u00ed v\u011bk rodi\u010dek, \u010dast\u011bj\u0161\u00ed v\u00edce\u010detn\u00e1 t\u011bhotenstv\u00ed spojen\u00e1 s\u00a0um\u011bl\u00fdm oplodn\u011bn\u00edm, ale tak\u00e9 hor\u0161\u00ed \u017eivotn\u00ed styl vedouc\u00ed k\u00a0\u0159ad\u011b civiliza\u010dn\u00edch onemocn\u011bn\u00ed, jako je cukrovka, vysok\u00fd krevn\u00ed tlak \u010di obezita, p\u0159isp\u00edvaj\u00ed k\u00a0tomu, \u017ee p\u0159ib\u00fdv\u00e1 \u017een, u kter\u00fdch se v\u00a0pr\u016fb\u011bhu t\u011bhotenstv\u00ed rozvine srde\u010dn\u00ed selh\u00e1n\u00ed. Jde o jednu z\u00a0nej\u010dast\u011bj\u0161\u00edch kardiovaskul\u00e1rn\u00edch komplikac\u00ed, se kterou se l\u00e9ka\u0159i u nast\u00e1vaj\u00edc\u00edch matek setk\u00e1vaj\u00ed. <\/strong><\/p>\n\n\n\n

Vedle jin\u00fdch onemocn\u011bn\u00ed srdce k\u00a0tomu p\u0159isp\u00edv\u00e1 tak\u00e9 tzv. peripart\u00e1ln\u00ed kardiomyopatie \u2013 ro\u010dn\u011b se tato nemoc v\u00a0\u010cesk\u00e9 republice vyskytne p\u0159ibli\u017en\u011b u 30 t\u011bhotn\u00fdch, ne v\u017edy je v\u0161ak spr\u00e1vn\u011b diagnostikov\u00e1na. Tak\u00e9 t\u00edmto t\u00e9matem se zab\u00fdvali specialist\u00e9 na mezin\u00e1rodn\u00edm kongrese Heart Failure 2023, kde n\u011bkolik sekc\u00ed organizuje \u010cesk\u00e1 kardiologick\u00e1 spole\u010dnost. Akce startovala 20. kv\u011btna 2023 v\u00a0Praze.<\/strong><\/p>\n\n\n\n

\u201eS t\u011bhotenstv\u00edm je spojena vy\u0161\u0161\u00ed hemodynamick\u00e1 z\u00e1t\u011b\u017e. To znamen\u00e1, \u017ee srdce mus\u00ed p\u0159e\u010derp\u00e1vat v\u011bt\u0161\u00ed objem krve, proto\u017ee v\u00a0dob\u011b t\u011bhotenstv\u00ed se jej\u00ed mno\u017estv\u00ed zv\u00fd\u0161\u00ed. Proto m\u016f\u017ee v\u00a0tomto obdob\u00ed doj\u00edt k\u00a0odhalen\u00ed srde\u010dn\u00ed choroby, kter\u00e1 se do t\u00e9 doby v\u016fbec nijak klinicky neprojevovala,\u201c <\/em>vysv\u011btluje prof. MUDr. Jan Krej\u010d\u00ed, p\u0159ednosta I. intern\u00ed kardioangiologick\u00e9 kliniky FN u sv. Anny v\u00a0Brn\u011b. Jednou z\u00a0nejnebezpe\u010dn\u011bj\u0161\u00edch srde\u010dn\u00edch komplikac\u00ed v\u00a0dob\u011b t\u011bhotenstv\u00ed nebo t\u011bsn\u011b po porodu je tzv. peripart\u00e1ln\u00ed kardiomyopatie<\/strong>. Vznik\u00e1 a\u017e v\u00a0z\u00e1v\u011bru t\u011bhotenstv\u00ed u \u017een, kter\u00e9 d\u0159\u00edve \u017e\u00e1dn\u00e9 srde\u010dn\u00ed pot\u00ed\u017ee nem\u011bly, a vede k\u00a0t\u011b\u017ek\u00e9mu srde\u010dn\u00edmu selh\u00e1n\u00ed \u2013 tedy stavu, kdy srdce nen\u00ed schopn\u00e9 p\u0159e\u010derp\u00e1vat pot\u0159ebn\u00e9 mno\u017estv\u00ed krve do v\u0161ech \u010d\u00e1st\u00ed t\u011bla.<\/p>\n\n\n\n

Nebezpe\u010dn\u00e9 srde\u010dn\u00ed onemocn\u011bn\u00ed prozrad\u00ed otekl\u00e9 kotn\u00edky, du\u0161nost, \u010dast\u00e1 \u00fanava nebo n\u00e1hl\u00e9 p\u0159ib\u00edr\u00e1n\u00ed na hmotnosti. V\u0161echny tyto p\u0159\u00edznaky ov\u0161em v\u00a0men\u0161\u00ed \u010di v\u011bt\u0161\u00ed m\u00ed\u0159e prov\u00e1z\u00ed v\u011bt\u0161inu t\u011bhotn\u00fdch. Proto je obt\u00ed\u017en\u00e9 nemoc odhalit. <\/p>\n\n\n\n

\u201eJe t\u0159eba t\u011bmto p\u0159\u00edznak\u016fm v\u011bnovat zv\u00fd\u0161enou pozornost a nesv\u00e1d\u011bt v\u0161e jen na prob\u00edhaj\u00edc\u00ed t\u011bhotenstv\u00ed. Alarmuj\u00edc\u00ed by pro \u017eeny m\u011blo b\u00fdt, pokud se jim h\u016f\u0159 d\u00fdch\u00e1 a jsou unaven\u00e9 p\u0159i minim\u00e1ln\u00ed n\u00e1maze nebo dokonce v\u00a0klidov\u00e9m re\u017eimu,\u201c<\/em> upozor\u0148uje prof. Krej\u010d\u00ed. Nemoc pomohou rozeznat krevn\u00ed testy a ultrazvukov\u00e9 vy\u0161et\u0159en\u00ed srdce, kter\u00e9 v\u0161ak nejsou sou\u010d\u00e1st\u00ed b\u011b\u017en\u00fdch t\u011bhotensk\u00fdch vy\u0161et\u0159en\u00ed. P\u0159i probl\u00e9mech v\u00a0t\u011bhotenstv\u00ed obvykle \u017eeny jako prvn\u00edho kontaktuj\u00ed gynekologa, kter\u00fd by v\u00a0p\u0159\u00edpad\u011b podez\u0159en\u00ed na srde\u010dn\u00ed onemocn\u011bn\u00ed m\u011bl prov\u00e9st laboratorn\u00ed vy\u0161et\u0159en\u00ed na stanoven\u00ed hladin tzv. natriuretick\u00fdch peptid\u016f a p\u0159i jejich zv\u00fd\u0161en\u00ed doporu\u010dit kardiologick\u00e9 vy\u0161et\u0159en\u00ed.<\/p>\n\n\n\n

Jeho kl\u00ed\u010dovou sou\u010d\u00e1st\u00ed je echokardiografick\u00e9 vy\u0161et\u0159en\u00ed, podle n\u011bho\u017e kardiolog stanov\u00ed z\u00e1va\u017enost posti\u017een\u00ed a navrhne vhodnou l\u00e9\u010dbu. Farmakoterapie srde\u010dn\u00edho selh\u00e1n\u00ed za posledn\u00ed roky zaznamenala obrovsk\u00fd pokrok, novinkou je vyu\u017eit\u00ed gliflozin\u016f, kter\u00e9 dok\u00e1\u017e\u00ed zlep\u0161it funkci srde\u010dn\u00edho svalu, a v\u00fdznamn\u011b tak prodlu\u017euj\u00ed \u017eivot pacient\u016f. Kv\u016fli mo\u017en\u00e9mu ohro\u017een\u00ed d\u00edt\u011bte v\u0161ak u t\u011bhotn\u00fdch tyto l\u00e9ky pou\u017e\u00edt nelze. <\/p>\n\n\n\n

\u201eV t\u011bhotenstv\u00ed jsou na\u0161e mo\u017enosti l\u00e9\u010dby velmi omezen\u00e9. Existuj\u00ed podrobn\u00e9 medic\u00ednsk\u00e9 postupy pro konkr\u00e9tn\u00ed stupe\u0148 srde\u010dn\u00edho posti\u017een\u00ed, v\u00a0nejt\u011b\u017e\u0161\u00edch p\u0159\u00edpadech s\u00a0ohro\u017een\u00edm \u017eivota matky je nutn\u00e9 dokonce p\u0159eru\u0161it graviditu bez ohledu na st\u00e1\u0159\u00ed plodu, v\u00a0\u0159ad\u011b p\u0159\u00edpad\u016f je nutn\u00fd porod c\u00edsa\u0159sk\u00fdm \u0159ezem. Dobrou zpr\u00e1vou je, \u017ee po porodu a n\u00e1sledn\u00e9m zaveden\u00ed komplexn\u00ed medikace je velk\u00e1 \u0161ance, \u017ee se stav srdce v\u00fdrazn\u011b zlep\u0161\u00ed,\u201c <\/em>dopl\u0148uje prof. Krej\u010d\u00ed.<\/p>\n\n\n\n

Dne\u0161n\u00ed medic\u00edna umo\u017e\u0148uje ot\u011bhotn\u011bt a donosit zdrav\u00e9 d\u00edt\u011b i \u017een\u00e1m, kter\u00e9 maj\u00ed n\u011bjak\u00e9 srde\u010dn\u00ed onemocn\u011bn\u00ed. Podle l\u00e9ka\u0159\u016f je v\u0161ak pot\u0159eba takov\u00e9 t\u011bhotenstv\u00ed pl\u00e1novat a upravit kv\u016fli n\u011bmu l\u00e9\u010dbu. \u201eSetk\u00e1v\u00e1me se s\u00a0t\u00edm, \u017ee n\u011bkter\u00e9 t\u011bhotn\u00e9 trp\u00ed vrozenou srde\u010dn\u00ed vadou, d\u011bdi\u010dnou chorobou srde\u010dn\u00edho svalu nebo maj\u00ed vy\u0161\u0161\u00ed tlak. V\u00a0takov\u00fdch p\u0159\u00edpadech je d\u016fle\u017eit\u00e1 \u00fazk\u00e1 spolupr\u00e1ce o\u0161et\u0159uj\u00edc\u00edho gynekologa a kardiologa. Ty p\u0159\u00edpady jsou dnes \u010dast\u011bj\u0161\u00ed p\u0159edev\u0161\u00edm kv\u016fli vy\u0161\u0161\u00edmu v\u011bku rodi\u010dek,\u201c<\/em> popisuje prof. MUDr. Ale\u0161 Linhart, p\u0159edseda \u010cesk\u00e9 kardiologick\u00e9 spole\u010dnosti.<\/p>\n\n\n\n

Zdrav\u00e9 d\u011bti porodily dokonce \u017eeny po transplantaci srdce. \u201eV\u00edm minim\u00e1ln\u011b o \u010dty\u0159ech \u010desk\u00fdch \u017een\u00e1ch po transplantaci srdce, kter\u00e9 se nenechaly p\u0159esv\u011bd\u010dit, aby pro mate\u0159stv\u00ed zvolily jinou cestu ne\u017e vlastn\u00ed t\u011bhotenstv\u00ed, a nakonec porodily zdrav\u00e9 d\u00edt\u011b. T\u011bmto \u017een\u00e1m t\u011bhotenstv\u00ed kv\u016fli \u0159ad\u011b rizik nedoporu\u010dujeme, pokud v\u0161ak na\u0161e doporu\u010den\u00ed nep\u0159ijmou, je u nich p\u0159ed ot\u011bhotn\u011bn\u00edm nezbytn\u00e9 upravit imunosupresivn\u00ed l\u00e9\u010dbu, kterou ov\u0161em kv\u016fli riziku odhojen\u00ed srde\u010dn\u00edho \u0161t\u011bpu nelze zcela vysadit,\u201c<\/em> varuje prof. Krej\u010d\u00ed.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Vy\u0161\u0161\u00ed v\u011bk rodi\u010dek, \u010dast\u011bj\u0161\u00ed v\u00edce\u010detn\u00e1 t\u011bhotenstv\u00ed spojen\u00e1 s\u00a0um\u011bl\u00fdm oplodn\u011bn\u00edm, ale tak\u00e9 hor\u0161\u00ed \u017eivotn\u00ed styl vedouc\u00ed k\u00a0\u0159ad\u011b civiliza\u010dn\u00edch onemocn\u011bn\u00ed, jako je cukrovka, vysok\u00fd krevn\u00ed tlak \u010di […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":16282,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-39791","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/39791","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=39791"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/39791\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/16282"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=39791"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=39791"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=39791"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}