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Maternal heart disease and pregnancy outcome: A single‐centre experience

2008; Elsevier BV; Volume: 10; Issue: 9 Linguagem: Inglês

10.1016/j.ejheart.2008.07.017

1879-0844

Verena Stangl, Johanna Schad, Gabriele Gossing, Adrian C. Borges, Gert Baumann, Karl Stangl,

Cardiac Arrhythmias and Treatments

Maternal and neonatal complication rates are increased in pregnant women with heart disease. Cardiac risk assessment may be improved by defining low and high-risk groups.To analyze pregnancy risks in low and high-risk women with cardiovascular diseases.Pregnancy outcomes were analyzed in 93 consecutive women with heart disease, monitored in a single-centre cohort between 1996 and 2006. Women were classified according to pre-defined risk predictors as high-risk (left ventricular [LV] ejection fraction < 50%, NYHA class > II or cyanosis, peak LV outflow gradient > 60 mmHg) or low-risk (not meeting these criteria). Mean age was 28.1+/-5.7 years. 81.7% presented with congenital, 10.8% with acquired heart disease, and 7.5% with myocardial diseases. Severe maternal complications developed in 12.9% of all women: 6.5% heart failure, 3.2% arrhythmias, and 2.2% thrombotic complications. Maternal mortality was 1.1%. Women at high-risk (24.7%) had a 6.1-fold higher maternal complication rate and a 6.1 times higher foetal/neonatal event rate (abortion and stillbirth). 64.7% of the high-risk women delivered prematurely, before the 37th week, compared to 16.4% in the low-risk group.Despite pronounced clinical variability of congenital and acquired heart diseases, a small number of risk conditions can effectively characterize women in whom pregnancy is associated with appreciably increased maternal and foetal risk.