Assisted reproductive technologies and metabolic syndrome complications: medico-legal reappraisal

doi: 10.7417/CT.2019.2161

  • D. Baldini Momo Fertilife IVF Center, Bisceglie, Italy
  • R. Beck Department of Anesthesia, Santa Maria Hospital, GVM Care & Reasearch, Bari
  • F. Negro Department of Anatomical, Histological, Forensic and Orthopedic Sciences, “Sapienza“ University of Rome, Rome
  • D. De Viti Department of Cardiology, Cardiac Surgery and Intensive care Unit, Santa Maria Hospital, GVM Care & Reasearch, Bari, Italy

Abstract

In the last 40 years, the number of elderly patients that require Assisted Reproductive Technologies (ART) has risen enormously, especially after heterolougus fertilization techniques have become available. In recent years, the incidence of peripartum cardiomyopathy (PPCM) has substantially grown, as a consequence of the combined effect of increased maternal age, consequent high prevalence of hypertension and metabolic syndrome (MS).
That cohort of women may be exposed to a greater number of cardiac, obstetric and anesthesio-logical complications, therefore the incidence of medico-legal issues, litigation, liabilities and claims over the past years has significantly risen. Cardiovascular and hormonal changes during pregnancy can challenge even the healthiest of individuals, and in that pregnant population the risk is even greater.
These patients should be monitored before the ART, during pregnancy, delivery and puerperium, to avoid heart failure, thrombotic problems, embolic complications, stroke and death. Management issues regarding pregnancy and delivery are elaborate, including anesthesia considerations. This new population of women needs an accurate cardiac risk stratification with a thorough cardiovascular history and examination, 12 lead ECG, and transthoracic echocardiogram.
Therefore, a comprehensive multidisciplinary assessment and management can provide the best opportunity to improve maternal and neonatal outcomes

Published
2019-09-30
How to Cite
BALDINI, D. et al. Assisted reproductive technologies and metabolic syndrome complications: medico-legal reappraisal. La Clinica Terapeutica, [S.l.], v. 170, n. 5, p. e364 - e367, sep. 2019. ISSN 1972-6007. Available at: <http://www.clinicaterapeutica.it/ojs/index.php/ClinicaTerapeutica/article/view/488>. Date accessed: 22 oct. 2019.