Prospective evaluation from single centre of pregnancy in women with congenital heart disease.

Abstract

OBJECTIVES:

Study of outcomes of pregnancy in women with congenital heart disease.

MATERIAL AND METHODS:

The cardiac state during and after pregnancy was analysed in 173 women (mean age 28 years, range 21-41) referred for fetal echocardiography and evaluation of maternal heart during 201 pregnancies. Acyanotic lesions were present in 152 women (100 operated), in 175 pregnancies; cyanotic lesions in 21, all operated, in 26 pregnancies. Eighteen patients in 20 pregnancies (9.9% pregnancies) presented an increased risk due to severe arrhythmias or relevant residual hemodynamic lesions (risk group).

RESULTS:

Complications related to heart defects occurred in 9/201 (4.5%), pregnancies: in 6/175 (3.4%) pregnancies with acyanotic lesions, in 3/26 (11.5%) with cyanotic lesions and in 9/20 pregnancies of the risk group (45%), with a statistically significant difference with respect to the non-risk group. Two cases had serious tachyarrhythmias, five worsened hemodynamic state or cyanosis, one had hemorrhage post-partum on anticoagulants and one died of a rupture of isthmic aneurysm post-coarctectomy. Prematurity occurred in 19.2% of pregnancies with cyanotic and 5.7% with acyanotic lesions. There were 6/201 recurrences of cardiac anomaly (3%).

CONCLUSIONS:

Patients with uncomplicated heart disease had normal course of pregnancy, while complications due to serious arrhythmias or residual hemodynamical lesions and cyanosis occurred in 4.5% of pregnancies and, mainly in 45% of those with increased risk. Thorough evaluation of the cardiologic risk is mandatory for a correct counseling of women planning pregnancy.

• Authors: Vlasta M E Fesslova', Laura Villa, Massimo Chessa, Gianfranco Butera, Sarah Salmona, Barbara Acaia
• Journal: International journal of cardiology (Int J Cardiol) Vol. 131 Issue 2 Pg. 257-64 (Jan 09 2009) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 18191250 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Topics

• Adult
• Female
• Heart Defects, Congenital (epidemiology, physiopathology)
• Humans
• Infant, Newborn
• Pregnancy
• Pregnancy Complications, Cardiovascular (epidemiology, physiopathology)
• Pregnancy Outcome (epidemiology)
• Prospective Studies
• Young Adult