Entry to the UK Market and Subsidiary Management Plan
This paper is a case study analysis report on the entry of Handelsbanken Bank into the UK market. The report briefly introduces the bank’s history, culture instilled in its employees, and financial status. After understanding the bank’s background, the case study analysis continues evaluating its mode of entry into the UK market compared to other banks. The paper reviews the Uppsala mode of internationalization as illustrated by the bank’s internationalization strategy. The paper also analyses the bank’s staffing approach and sustainability framework in the UK. The frameworks covered include polycentric and economic responsibility frameworks, respectively. Generally, the bank has grown tremendously after entering a new market, as illustrated in the study. Despite its growth, the report recommends further marketing ideas for the bank to attain maximum financial sustainability.
On 1 July 1871, the bank commenced its operations at Kornhamnstorg, located in the Old Town area of Stockholm, which was the primary hub for commerce and finance in the city at that time (Chopra, 2017). During that period, the majority of commercial banks in Sweden were categorized as “private” (known as “enskilda” in Swedish) banks, wherein the proprietors held joint and several liabilities for the bank’s obligations. In contrast, Handelsbanken was established as a corporation with restricted liability for its proprietors. The initial public offering of Handelsbanken’s shares occurred in August 1871 on the Stockholm Stock Exchange (Chopra, 2017). After this, the initial branches were established in Stockholm, with the first one being inaugurated in the Södermalm area in 1876, followed by the Norrmalm branch in 1878, and the Östermalm branch in 1882. 1874 the bank established a branch in Jönköping, which was subsequently terminated in 1895 (Whittington et al., 2019). Following the conclusion of World War II, Handelsbanken proceeded to augment its presence in Sweden by procuring smaller rival entities. Expanding internationally was precluded due to regulated national banking markets being closed to foreign players (Chopra, 2017). Moreover, regulations imposed restrictions on banks’ autonomy within the domestic sphere. Nonetheless, Handelsbanken exhibited strong financial performance and solidified its position as a prominent participant in the Swedish banking industry.
The organization exhibits remarkable prowess concerning its corporate values. The values of an organization serve as a fundamental support system for every employee. Chopra (2017) states that a proactive culture facilitates decision-making, behavior, and communication. The outcome is favorable as it transforms values into a cultural framework, subsequently shaping customer experiences. This generates a tangible outcome for the staff. A set of values guides the organization and does not prioritize using ostentatious slogans. “Our Way” delineates the recommended approach for Handelsbanken to conduct its banking operations, including selecting customers and employees, loan disbursement procedures, communication protocols, and various other aspects (Chopra, 2017).
From 2009 to 2020, there was an upward trend in the mean number of personnel employed by Handelsbanken, a financial institution based in Sweden. In 2021, the bank’s workforce comprised 12,240 individuals, indicating a marginal decline compared to the preceding year (Statista Research Department, 2022). Handelsbanken has set a target to achieve a representation of 30% female leaders by 30 June 2021 and a further target of 40% female leaders by 2026. The organization is cognizant that it may need to achieve its objectives for the year 2021. Nevertheless, it is steadfast in its resolve to adopt a strategic, long-term perspective and establish sustainable transformation and advancement as it sets its sights on 2026. The Swedish bank’s financial report indicates a net profit of 6.81 billion Swedish kronor ($660.7 million), an increase from the previous year’s profit of SEK5.69 billion (Chopping, 2023). This figure is also compared to a FactSet consensus forecast of SEK6.12 billion. The net interest income experienced an increase to SEK11.49 billion from SEK8.01 billion, surpassing the projected amount of SEK11.01 billion (Chopping, 2023). The escalation of interest rates has exerted a distinct influence on the real estate sector, owing to the augmented financing expenses when loans reach maturity and require refinancing.
Analysis and discussion
Handelsbanken Bank’sentry to the UK
During the 1980s, Handelsbanken established multiple branch offices in various countries to support its corporate banking operations. Since 1990, the bank has procured several smaller banks within the Nordic region in Norway, Finland, and Denmark. The bank commenced its operations in Denmark, Finland, and Norway proficiently in 1998 (Whittington et al., 2019). In 1999, Handelsbanken expanded its presence in the United Kingdom through organic growth. The bank commenced operations in the United Kingdom in 2002 as an additional regional bank.
Regarding the entry mode, Handelsbanken adopts a strategy of establishing a branch to enter the global market. The operations of the Swedish bank are subject to limitations imposed by regulatory frameworks within its domestic jurisdiction and in foreign territories—the regulations at the national level permitting solely minor operations in foreign markets. Foreign banking ventures were prohibited from operating on the mainland by other countries. The internationalization options and decisions of Swedish banks were limited. Since the 1990s, changes in circumstances have occurred due to foreign and domestic deregulation, which has enabled Swedish banks to expand their foreign ownership and increase their international presence (Chopra, 2017). According to the case study, the approach to developing branches in most areas of the UK serves as the internationalization model they used.
The company used an Uppsala model in conjunction with the internationalization approach. The Uppsala model is a theory that defines the approach a company like Handelsabanken Bank used to intensify its activity in foreign markets, which in this case include the United Kingdom and other nations in Europe. The Uppsala model was developed in Sweden (Hult et al., 2020). According to Igwe et al. (2021), in the Uppsala model, the business considers the fact that it needs an understanding of overseas markets before beginning to work on expanding its client network by establishing connections with other businesses and the government. This made Handelsbanken an early entrant in the UK market. In addition, it moderately interacted with other businesses on matters of growth and profitability. The Handelsbanken’s first steps into the international market were exploratory ones. After that, it expanded its international company into the 21st century by quickly duplicating its previously acquired knowledge up until the middle of the 1990s. After that, the company used a more adaptable approach to its replication strategy. As a result, it successfully codified the ideas behind the Handelsabanken Idea Concept and Concept in Practice, making it possible to replicate and modify the strategies with relative ease in new markets (Igwe et al., 2021).
The expeditious expansion of the financial institution can be attributed to the robust fiscal standing of its Swedish pioneer organization. The primary emphasis is exercising caution in lending practices and minimizing losses incurred from non-performing loans rather than diversifying into more transient customer relationships. Using a Greenfield entry mode, the bank managed to start its branches from the ground up. Greenfield foreign direct investment is one of the many options available to companies looking for opportunities to expand into new marketplaces (Rienda et al., 2019). This type of investment functions as a foray into the markets of other countries.
Handelsbanken’s organizational structure is highly decentralized and tailored to meet the specific needs of its customers (Whittington et al., 2019). This enables efficient decision-making concerning the bank’s relationships with individual customers. The bank operates in close collaboration with the customer. Handelsbanken initiated its initial overseas ventures independently but subsequently adopted a strategy of forming consortia with other banks from the Scandinavian region. Comparable approaches were adopted by the rivals of Handelsbanken, namely Kansallis of Finland, Köpenhamns Handelsbank of Denmark, and Den Norske Kreditbank of Norway (Chopra, 2017). Kansallis-Osake-Pankki, recognized as the most prominent commercial bank in Finland for a considerable period, has evolved into a diverse financial-services entity. Kansallis-Osake-Pankki, the parent organization of the Kansallis Banking group, exercises control over five primary sectors as per a reorganization implemented in January 1988 (Pohl, 1994). These sectors include corporate banking, retail and private banking, international banking, investment banking, and domestic and international trading. According to the case study, Kansallis-Osake-Pankki Bank used the same expansion model used by Handelsbanken Bank. However, the competing banks operated on shared costs in their internationalization process. Therefore, the competitors had a joint venture mode of entry. Since they came after Handelsbanken, this competitor is considered a late entrant into the UK market. The rationale underpinning this strategy was straightforward; by collaborating, the financial institutions could reduce expenses while enhancing their knowledge of global markets (Whittington et al., 2019). Given that each consortium was perceived as a service organization catering to its domestic customers, no intra-consortium competition existed. Nevertheless, divergent viewpoints regarding the objectives and functions of the consortia resulted in their dissolution after a few years, prompting the banks to revert to a tactic of establishing wholly-owned representative offices.
Analysis of UK Subsidiary Management Strategies
Handelsbanken Bank’s staffing policies for its UK subsidiary
Handelsbanken plc is a subsidiary fully owned by Svenska Handelsbanken AB (publ). The success of Handelsbanken plc is the collective responsibility of its Board of Directors, who are independently governed and accountable to the shareholders. As per the case study’s findings, the availability of a suitable branch manager was deemed to be of greater significance than the geographical location when selecting new branch locations. Handelsbanken may delay its entry into a promising local market without a branch manager who fully embraces the decentralized approach to banking culture. Following Handelsbanken’s decentralization approach, the branch manager is anticipated to exercise significant autonomy in managing their respective branch (Chopra, 2017). This is to be done while maintaining a cost-effective and moderately cautious approach to banking.
The model exhibited by the bank in terms of staffing during its entry into the UK is mainly a polycentric approach. The polycentric strategy assumes that people from the host country will be employed “from top to bottom of the organization” (Que, 2022). The local staff of the host nation is given additional authority with this strategy. The strategy is predicated on the idea that natives of the host country are more familiar with the specifics of the local market and may thus be more effective. Additionally, the country where it operates needs a distinct HR department. Because it offers additional opportunities and demonstrates the company’s dedication to the host nation, the local community typically receives the polycentric strategy (Que, 2022). Handelsbanken exhibits the illustration of this strategy during its entry. The bank showed a specific interest in recruiting seasoned bankers who had previously worked at central clearing or mid-sized banks and expressed dissatisfaction with the growing trend of centralization within their respective institutions.
Upon the bank’s inception, many newly appointed branch managers exhibited a strong inclination towards the concept of decentralization, displaying enthusiasm in recruiting their colleagues and implementing logistical arrangements within the office (Whittington et al., 2019). The case study illustrates the Leeds branch manager who demonstrated a strong commitment to the cost-conscious culture of Handelsbanken. The individual procured the office furniture at a discounted price and adorned the workspace with paintings crafted by his spouse, instead of acquiring costly artwork from an art establishment. The narrative of his experience gained widespread recognition within the British operations as a commendable illustration of implementing Handelsbanken’s culture of cost-consciousness and decentralized decision-making, which also plays a part in its sustainability approaches.
Handelsbanken Bank’s CSR and Sustainability approaches in the UK
Handelsbanken’s image as a mass market provider with street-level branches is prevalent in Nordic countries. However, Handelsbanken has positioned itself as a traditional private bank in the United Kingdom. As per the case study, the clientele was selectively chosen, wherein the branches sought lucrative enterprises and affluent individuals to engage with. Handelsbanken in the UK mitigates the likelihood of acquiring an unprofitable client portfolio by proactively seeking out customers rather than relying solely on customers to approach the bank (Whittington et al., 2019). Additionally, the management formulates strategic initiatives, such as expanding outreach to local clientele or accelerating growth. In 2006, Handelsbanken’s management decided to increase the pace of opening new branches for the following year, 2007, due to the rapid profitability of the British branches and the seemingly boundless market. The acceleration of organic growth resulted in a significant expansion within the territory of Great Britain.
Based on the review of their sustainability strategy above, the organization’s main framework is the economic responsibility framework. The concept of economic responsibility pertains to the act of making financial choices grounded on a dedication to ethical conduct (Olanipekun et al., 2021). In order to maintain economic accountability, corporate executives are faced with the task of transcending mere operational expenditure reduction and prioritizing their responsibility to corporate social responsibility in all financial deliberations, as exemplified by the banking decision of the Leeds manager. Like Handelsbanken Bank’s sustainability strategy, economic responsibility pertains to the practices that enable the business to achieve long-term growth while simultaneously adhering to the standards established for ethical, legal, and philanthropic practices (Negi et al., 2020). Although the company had initially set social objectives upon entering the market, its primary approach for market entry in the UK was cost-consciousness and profit maximization (Sustainability n.d).
Handelsbanken is a regional financial institution that prioritized customer satisfaction, financial stability, and sustainable principles during its entry. Every branch functioned as a regional enterprise, enabling them to understand their clientele and the local market and community comprehensively. Today, Handelsbanken is pursuing a strategy that integrates digitalization with a local presence. Handelsbanken has successfully adapted a branch-based business model to changes in the business environment, despite prior predictions that it would become obsolete. Nevertheless, it remains uncertain whether this trend will persist in the future. The bank has effectively aligned its objectives most suitably through a strategic approach. The organizational structure and culture facilitate the effective allocation of resources, resulting in optimal outcomes. Through this approach, the entity developed enduring objectives that prioritize sustainability. This facilitated the achievement of the dependable objectives outlined in the memorandum.
One of the key recommendations for the bank is incorporating a segmentation marketing strategy. Market segmentation refers to the practice of Svenska Handelsbanken dividing the broader market into smaller segments and groups that share common characteristics, purchasing patterns, socio-economic backgrounds, and other relevant factors. This approach is implemented to enhance the efficiency and effectiveness of consumer outreach to a specific group. A good example entails geographic segmentation. Geographic segmentation involves partitioning the entire market into distinct geographic units, including countries, continents, zip codes, states, trading blocks, cities, and neighborhoods. Using geographic segmentation is a highly effective strategy for Svenska Handelsbanken in the global marketplace, as it allows for identifying and targeting potential customers with varying cultural backgrounds, preferences, and administrative structures. If transportation expenses are a significant factor in delivering value propositions, it would be advisable to conduct geographic segmentation. This is because the costs of serving customers in various locations may vary significantly.
Chopping, D. (2023) Handelsbanken First-Quarter Net Profit Beat Forecasts on Higher Net Interest Income, SVENSKA HANDELSBANKEN AB (SHB A). Available at: https://www.marketscreener.com/quote/stock/SVENSKA-HANDELSBANKEN-AB-22252916/news/Handelsbanken-First-Quarter-Net-Profit-Beat-Forecasts-on-Higher-Net-Interest-Income-43638663/ (Accessed: 19 May 2023).
Chopra, A. (2017). Handelsbanken: Banking done differently -olof Brunninge, Academia.edu. Available at: https://www.academia.edu/34690036/Handelsbanken_banking_done_differently_Olof_Brunninge (Accessed: 18 May 2023).
Hassan, T.U. and Berg, J., 2022. An analysis of factors affecting the internationalization of traditional banks: A case study of traditional banks based in Sweden.
Hult, G.T.M., Gonzalez-Perez, M.A. and Lagerström, K., 2020. The theoretical evolution and use of the Uppsala Model of internationalization in the international business ecosystem. Journal of International Business Studies, 51, pp.38-49.
Igwe, P.A., Rugara, D.G. and Rahman, M., 2021. A Triad of Uppsala Internationalization of Emerging Markets Firms and Challenges: A Systematic Review. Administrative Sciences, 12(1), p.3. https://doi.org/10.3390/admsci12010003
Negi, A., Pérez-Pineda, J.A. and Blankenbach, J., 2020. Sustainability standards and global governance: Experiences of emerging economies (p. 224). Springer Nature.
Olanipekun, A.O., Omotayo, T. and Saka, N., 2021. Review of the use of Corporate Social Responsibility (CSR) tools. Sustainable Production and Consumption, 27, pp.425-435. https://doi.org/10.1016/j.spc.2020.11.012
Pohl, M. 1994 Chapter : Kansallis-Osake-Pankki, Elgar Online: The online content platform for Edward Elgar Publishing. Available at: https://doi.org/10.4337/9781781954218.00039 (Accessed: 18 May 2023).
Que, C.A., 2022. Human Resources International Organizations.
Rienda, L., Claver-Cortes, E., Quer, D. and Andreu, R., 2019. Greenfield investments or acquisitions? The influence of distance on emerging-market multinationals. Management Decision, 57(5), pp.1223-1236. https://doi.org/10.1108/MD-02-2017-0154
Statista Research Department, 2022 Handelsbanken: Number of employees 2021, Statista. Available at: https://www.statista.com/statistics/1051371/number-of-handelsbanken/ (Accessed: 19 May 2023).
Sustainability (no date) Handelsbanken. Available at: https://www.handelsbanken.com/en/sustainability/sustainability-report (Accessed: 19 May 2023).
Whittington, R., Angwin, D., Regner, P., Johnson, G., Scholes, K. and Koleva, P., 2019. Exploring strategy, text, and cases. Pearson Education.
Is Intelligence A Part Of Creativity? Free Sample
Intelligence and creativity have formed the cornerstone of studies in the educational system and psychology for a long time, with a key question being; is intelligence a part of creativity? Based on their co-occurrence, it is easy to confuse or mistake intelligence and creativity or completely miss the existing relationships. Scientists have tried to lessen this problem by examining, through a scientific approach, the relationship between intelligence and creativity, especially for gifted persons. Their findings on this relationship have often been tested using an approach that connects both to giftedness. Using this approach, three prepositions emerge; intelligence is necessary for creativity; creativity types arise from levels of intelligence; and giftedness is a balance between intelligence and creativity.
One way to affirm the relevance of intelligence to creativity or to confirm that intelligence is part of creativity is to use the Intelligence Quotient or IQ. In several studies, creativity is exposed at Intelligence Quotient (IQ) of 120. As such studies affirm, persons with intelligence levels below this standard cannot achieve creativity (Akhtar & Kartika, 2019). The evidence is presented from a wide range of samples in the different studies. The study by Olamafar et al. (2022) was carried out on 532 students between 15 and 18 years, out of which 70 scored 120 on the intelligence scale (Raven’s scale). These students were further subjected to a creativity test (Abdi-Schumacher), which revealed that those whose intelligence score was 120 also scored well on creativity. This finding confirmed the 120 IQ threshold for creativity to exhibit. This study revealed that intelligence is part of creativity. Furthermore, Nakano et al. (2021) conducted a study on 966 17-year-old gifted students. The results showed a positive and significant correlation, which confirmed that intelligence and creativity are positively related. As seen in the two studies, the 120 threshold is an important testament that for creativity to expose, there is a baseline of intelligence. It is an affirmation of the relevance of intelligence in creativity. Some studies also looked into higher intelligence versus higher creativity. These studies revealed that higher intelligence did not correlate with creativity (Olamafar et al., 2022). This means that intelligence only correlated with creativity at the established score of 120 and no higher. Thus, these studies confirm the centrality of intelligence in the occurrence of creativity while also affirming the 120 IQ threshold as the optimal level beyond which intelligence has no further correlation with creativity.
The use of intelligence to determine creativity is gaining importance as the connection becomes clearer. It is an easy way of helping society to understand why some people perform better in some creative aspects than others. Moreover, individual differences and individualized learning have become an important focus in academic and non-academic fields. Even though the 120 IQ score may not easily be decoded, the fact that it categorizes people against their predispositions or abilities means that it helps solve some of the problems related to understanding what people can achieve. This aspect is relevant in selecting careers. In addition, it becomes a practical focus for those aspiring to venture into creative talents. Similarly, for families grappling with career choices for their children, it becomes a yardstick and, therefore, something they can test. The reason is that intelligence tests are easy to administer once the purpose is clear. Besides families, the entertainment sector can also use the 120 IQ threshold to select those to engage in contracts. This assessment can be a good starting point in examining the potential of contracted artists to be creative enough to generate income. The bigger picture is that not everyone is gifted though they could be creative. Therefore, the 120 IQ threshold provides a simple mechanism to help families with career selections for their children.
Although the IQ element is very prominent, other points show intelligence as necessary for creativity. Related to the IQ levels is the type of intelligence versus the creative talents exposed. This line of thought contends that certain types of creative talents are more related to intelligence levels than others. This proposition was tested in the study by Nakano et al. (2021) by focusing on the total intelligence score against two creativity aspects: figural and verbal. It was found that whereas the total score correlated positively with verbal and figural creativity, the correlation was higher between intelligence score and verbal creativity than with figural creativity. It was concluded that the higher the intelligence, the greater the likelihood of exposure to verbal creative talents (Nakano et al., 2021). This relationship is highly exposed in society. However, it is a controversial one, given the existing views about artists. It is somehow thought that a general inability to progress in school by most artists somewhat confirms that their intelligence is below that of other professionals, such as doctors. The research on intelligence and creativity counters this claim and confirms that high intelligence can simply exhibit in one form of creativity and not necessarily all. Further, it is revealed that the ultimate goal is success in life in general. Thus, since artists such as rappers become influential and successful, they too qualify on the aspect of giftedness. This view solves the often cut-throat comparisons of professions. It identifies that instead of comparing professions, it is important to focus on what one desires to do, their giftedness in it, and what their intelligence supports. Therefore, the views on artists and their intelligence are areas society needs to re-evaluate amidst emerging information that confirms certain intelligence levels support some creative abilities more than others.
Another important consideration in the relationship between intelligence and creativity is the needed balance to reach giftedness. As Desmet et al. (2021) contend, giftedness requires the right proportions of intelligence and creativity. To this end, they must all exhibit at the same time, with specificity in giftedness. Their study on 710 seventh-grade students revealed that academic achievement was only present where inquisitiveness (creativity) was observed alongside high intelligence scores (Desmet et al., 2021). Their confirmatory study found that creativity alone could not explain or account for academic achievement.
Giftedness has always been studied in isolation. This is perhaps one of the early and critical reviews showing that this should not be the case. Instead of segregating students with giftedness, this review shows the need to identify what they could be gifted in more and the intelligence and creativity behind it. It is true that giftedness does not exist in isolation from creativity and intelligence. This means there can be a sure way of confirming giftedness and distinguishing it from bouts of passing enlightenment. The review confirms that intelligence and creativity are relatively stable when they occur together and thus should form the central point for confirming giftedness. Thus, these observations call into consciousness the consideration of intelligence and creativity measures in determining giftedness.
The above discussion answers the question of whether intelligence is part of creativity. The first argument contends that intelligence is necessary for creativity. According to this basic line of thought presented in the studies reviewed, there is no creativity without intelligence. Thus, creativity comes out of intelligence. The other conclusion from the studies relates to the insufficiency threshold. This threshold holds that despite intelligence being necessary, it is not enough to spur creativity. This is why high intelligence (above 120) does not correlate with increased creativity. This preposition does not counter the first one but confirms that intelligence is necessary to produce creativity. Besides the necessity and threshold, there is also the balance hypothesis, where it has been presented that for giftedness to expose, there must be a correct balance between intelligence and creativity. All these confirm the question and, thus, the hypothesis that intelligence is part of creativity.
Akhtar, H., & Kartika, Y. (2019). Intelligence and creativity: An investigation of thresholds
theory and its implications. Journal of Educational Psychology, 9(1), 131-138.
Desmet, O., Weerdenburg, M., Poelman, M., & Hoogeven, L. (2021). Validity and utility of the
test of creative thinking drawing production for Dutch adolescents. Journal of Advanced Academics, 32(1), 267-290.
Nakano, T. C., Ribeiro, W.J., & Virgolim A. M. (2021). Relationship between creativity and
intelligence in regular students and giftedness students. Psico-USF, 26(1), 103-116
Olamafar, M. M., Rajabi, M., Tajrishi, M. P., Adibsereshki, N., & Abadi, A. (2022). Association
between general intelligence, creativity and wisdom in gifted adolescents: Empirical findings from a non-western country. Current Psychology, 1-10.
Maternal Cardiovascular Events During Childbirth Among Women With Congenital Heart Disease Sample Paper
As per Li, Wenzhen, et al pg. 595, the total number of situations where congenital heart defects (CHD) have been steadily rising has been experienced during the last two decades. In fact, for two decades, it has surpassed the number of cases of all other types of abnormalities at birth that women experience. In addition, this type of condition has grown into a birth condition, which happens the most typically in the United States and other countries across the globe. Li, Wenzhen, et al pg. Five hundred ninety-nine went ahead and lamented that various Innovations in healthcare technology have contributed to a better effect for females with congenital heart conditions. This has been enabling them to give birth to babies that are healthy safely. Considering all of these advancements, maternal cardiovascular events (MCEs) after childbirth remain essential in maternal mortality and morbidity. This is particularly pertinent for females with coronary artery disease (CAD) (Li, Wenzhen, et al. pg. 602). The primary goal of this present research is to examine the risk variables that contribute to MCEs in this specific cohort. Additionally, the study will explore the potential implications for obstetrical treatment of women in this population.
Due to an array of parameters like underlying heart pathology, comorbidities, and gestational age, women with CHD continue to experience a greater likelihood of MCEs during their delivery. Consequently, ongoing surveillance and treatment of these patients are essential for the most effective obstetrical care.
Maternal Cardiovascular Events during Childbirth
According to Wu et al., pg. 1040), MCEs, occasionally called maternal cardiovascular events, are an essential variable in morbidity and mortality rates amongst expectant females. Women experiencing coronary heart disease (CHD) have a greater likelihood of MCEs because of their intrinsic cardiovascular pathology, comorbidities, and gestational age. Instances of hypertensive disorders comprise eclampsia and pregnancy-induced hypertension. Females with these ailments are likelier to encounter cardiac cases like heart attacks, strokes, and heart failure while giving birth. Possible unfavorable effects also include heart arrhythmias.
The high heart pace and blood volume factor of labor can occasionally trigger arrhythmias in ladies with heart conditions. The emphasis on the heart and blood vessels during childbirth may be a contributing rationale. Another cause for worry is the emergence of peripartum cardiomyopathy. PPCM is a strange kind of heart failure that typically manifests in the third trimester of pregnancy or within the first five months after delivery (Chakrabarti et al.). Strained heart muscles cannot pump blood effectively, leading to heart failure. Gestation and delivery increase a woman’s risk of developing life-threatening blood clots in the legs (deep vein thrombosis), which can then travel to the lungs and cause a pulmonary embolism. The stringency of the consequences can be mitigated by prompt diagnosis and treatment.
Underlying Cardiac Pathology
As lamented by Wu et al., pg. 1046 In their research, women suffering from CHD are highly likely to experience a higher probability of developing MCEs because of the underlying dysfunction of the heart. Women with congenital coronary artery disease might have a single fault, many flaws, or complex flaws. All these flaws elevate the possibility of maternal cardiovascular events (MCEs). Aortic stenosis is likely to contribute to an elevated risk of coronary artery disease and arrhythmias (Wu et al., pg. 1048). These two conditions can culminate in infarctions of the heart as well as fatalities (MCEs). Several cardiovascular anomalies, like those linked to tetralogy of Fallot, heighten the possibility of arrhythmias and the risk of cardiac failure. Patients with complex heart conditions like the inversion of the great arteries or tricuspid atresia have an increased likelihood of cardiogenic shock and death by cardiac arrest. These medical conditions tend to raise women’s risk of CHD-related MCEs.
As a result of various comorbidities and the root cause of cardiac disease that leads to CHD, women might have an increased likelihood of suffering from MCEs. Women with coronary heart disease are more inclined to become diagnosed with high blood pressure and diabetes. These two conditions may increase the possibility of MCEs. Being overweight is one condition that is more prevalent in women suffering from coronary heart disease and can raise the likelihood of maternal coronary artery disease.
Comorbid physical conditions during gestation include diabetes, hypertension, and autoimmune diseases. These problems must be continuously evaluated and treated to provide the best possible results for both mother and child (Sartorius, pg.52). Obstetricians, general care physicians, and mental health professionals must collaborate to manage comorbid illnesses during pregnancy properly, Achieve balance between endangering the baby is critical. Consistent monitoring, medication changes, counseling, and support can help the mother and her unborn child’s health.
Furthermore, in women experiencing CHD, gestational age can further increase the likelihood of MCEs. As a result of the premature growth and development of the systems of organs, women with CHD are more susceptible to giving birth at early gestational ages. This effect could put additional strain on the cardiovascular system because of the more significant strain on the cardiovascular system, which encompasses an increased likelihood of stroke, heart attack, and other cardiovascular diseases. These diseases may enhance the danger of getting MCEs. Premature delivery is additionally more probable at early gestational ages and increases one’s likelihood of heart problems and MCEs. To recognize and handle any potential danger indicators associated with early gestational age, it is of utmost importance to completely comply with mothers with CHD throughout their pregnancy.
Moreover, Congenital heart disease raises the risk of maternal cardiovascular events; thus, gestational age is only one factor among several. The physiological changes brought on during pregnancy are significant. Pregnancy necessitates substantial changes in the cardiovascular system to maintain the fetus. Changes in hormones, metabolism, and cardiovascular function happen. These physiologic variations can impact the heart and blood arteries of women with coronary heart disease (CHD). They can make pregnancy more difficult for the heart because of the heart and arterial abnormalities.MCE risk can be increased indirectly by CHD. Women with pulmonary hypertension, aortic or mitral valve disease, or untreated cyanotic heart disease are particularly vulnerable (Porter et al., pg.241). Pregnancy raises the risk of cardiovascular events in women who have certain conditions.
CHD caused by pregnancy needs close monitoring and competent treatment. Preconception counseling may help CHD women prepare for challenges throughout pregnancy. Pregnant women should frequently see obstetricians, cardiologists, and maternal-fetal medicine experts to safeguard both mother and child. MCEs in CHD mothers are influenced by various factors other than gestational age. Pregnancy-related physiological changes, preexisting cardiovascular difficulties, and specialized therapy and monitoring must all be considered. Doctors can reduce risks by assisting and treating pregnant women with CHD.
Implications for Obstetrical Care
It is necessary to take care of women with CHD through healthy monitoring and provision of appropriate treatment during their pregnancy and at the tie of their delivery to minimize maternal cardiovascular events (MCEs) risks. Pregnant women with hereditary heart disease ought to have their blood pressure, levels of glucose as well as cardiac function frequently evaluated. Patients should have periodic checks for arrhythmia and warning signs of cardiovascular disease. One significant outcome of advancements in prenatal screening and diagnosis is improved obstetric care. The discovery of genetic disorders and chromosomal anomalies in babies has been revolutionized by non-invasive prenatal testing. It has enhanced medical professionals’ diagnostic accuracy, timeliness, and interventions and facilitated better patient care through sound choices.
Ultrasounds, mainly 4D and 3D versions, have advanced to the point that they allow for in-depth monitoring of the developing fetus, which aids in detecting any abnormalities.
The immediate influence is the shift toward individualized and person-centered care. Obstetricians tailor their care to patients by considering patient history, lifestyle choices, and other personal preferences. The approach fosters a cooperative relationship between the mother and the medical staff by making her feel solid and capable. Advancements in labor management have also had a substantial impact on obstetrics. Electronic fetal monitoring (EFM) allows medical staff to track the baby’s heart rate and the mother’s contractions in real-time throughout labor. The gadget provides continuous feedback, so any signs of pain or difficulties may be quickly identified and treated. With the help of modern pain relief methods like nitrous oxides and epidurals, laboring mothers will better bear the discomforts of childbirth and have a more positive birth experience overall.
As more individuals have understood women’s physical and mental difficulties after giving birth, the provisions of postpartum help have risen in popularity. Clinical obstetrics now contains comprehensive postpartum care and support. It entails counseling on nursing, screening for mental illness, and assistance with postpartum problems. By managing these difficulties, obstetrics care enhances the mother’s overall health and facilitates a more natural transition into parenting. Healthcare specialists have to continuously monitor the patients they treat throughout their pregnancy and delivery to ensure they are getting enough oxygen to survive. The healthcare provider should ensure that a woman is at ease and well-cared for at all moments while in labor. This encompasses the supply of pharmaceuticals as required.
In conclusion, pregnant women with congenital heart disease have higher chances of experiencing cardiovascular complications after giving birth. However, this is just one instance of the complexity inherent in high-risk pregnancies. We have been able to equip ourselves with a clear comprehension of the prevalence of these occurrences, the variables that raise their risk, and the outcomes that result from their occurrence by consulting various resources. To offer adequate care for these pregnancies, a team effort including many different types of experts is required. As per the study results, the researchers support the idea that treatment should be provided according to the needs of each patient in the care setting.
Medical practitioners need to deeply understand the particular requirements of women with CHD in times of labor and giving birth; maternal and newborn results may be better. Broader implications stem from the study’s results, which call attention to the need to provide specialist medical care to those at risk and promote further research into the variables that affect maternal cardiovascular health. There is a similarity between Congenital cardiac disease, pregnancy, and maternal health in several forms that it was difficult for me to comprehend effectively until I commenced my research.
Chakrabarti, Anupam, et al. “ANAESTHETIC MANAGEMENT of a CASE of PERIPARTUM CARDIOMYOPATHY (PPCM): A CASE REPORT.” Jrapm.com Case Report Journal of Research in Anaesthesiology and Pain Medicine, vol. 2, 2016, scholar.archive.org/work/jcytc343jjddbikefkvrobbtca/access/wayback/jrapm.com/data_pdf/anupamchakraborty.pdf. Accessed 19 May 2023.
Li, Wenzhen, et al. “Parity and risk of maternal cardiovascular disease: a dose–response meta-analysis of cohort studies.” European Journal of preventive cardiology 26.6 (2019): 592-602.
Porter, Thomas R., et al. “Clinical Applications of Ultrasonic Enhancing Agents in Echocardiography: 2018 American Society of Echocardiography Guidelines Update.” Journal of the American Society of Echocardiography, vol. 31, no. 3, Mar. 2018, pp. 241–74, https://doi.org/10.1016/j.echo.2017.11.013. Accessed 19 May 2023.
Sartorius, Norman. “Depression and Diabetes.” Body-Mind Interaction in Psychiatry, vol. 20, no. 1, Mar. 2018, pp. 47–52, https://doi.org/10.31887/dcns.2018.20.1/nsartorius.
Wu, Pensee, Mamas A. Mamas, and Martha Gulati. “Pregnancy as a predictor of maternal cardiovascular disease: the era of CardioObstetrics.” Journal of Women’s Health 28.8 (2019): 1037–1050.