Portal de Periódicos da CAPES

Mode of delivery in pregnancies complicated by major fetal congenital heart disease: a retrospective cohort study

2014; Springer Nature; Volume: 34; Issue: 12 Linguagem: Inglês

10.1038/jp.2014.104

1476-5543

Colin Walsh, Aoife MacTiernan, S Farrell, Cecilia Mulcahy, Carrie McMahon, Orla Franklin, David Coleman, Rhona Mahony, Shane Higgins, S. Carroll, Peter McParland, Fionnuala M. McAuliffe,

Cardiac Structural Anomalies and Repair

To determine the mode of delivery in pregnancies complicated by complex fetal congenital heart disease (CHD). Five-year retrospective cohort study at a tertiary fetal medicine center (2007 to 2011). Cases of complex fetal CHD (n=126) were compared with 45 069 non-anomalous singleton infants ⩾500 g to determine rates of emergency intrapartum cesarean section (CS), preterm delivery and induction of labor. Intrapartum CS is significantly higher in fetal CHD than non-anomalous controls (21% vs 13.5%, odds ratio (OR) 1.7, 95% confidence interval (CI): 1.0 to 2.7; P=0.035), predominantly related to CS for non-reassuring fetal status (OR 2.2, 95% CI: 1.1 to 4.1; P=0.022). Although fetal CHD did not increase emergency CS rates in nulliparous women, CS was significantly increased in multiparous pregnancies (OR 2.4, 95% CI: 1.8 to 4.6; P=0.014). Rates of preterm delivery (OR 3.4, 95% CI: 2.0 to 5.4; P<0.0001) and induction of labor (OR 1.9, 95% CI: 1.3 to 2.9; P=0.001) were higher in the CHD cases. Emergency CS is increased in fetal CHD, attributed to a higher rate of CS for non-reassuring fetal status and seen mostly in multiparous women.