Haemorrhagic and thrombotic complications in pregnant women with acquired and congenital cardiac disease
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Barry Kevane
Abstract
Background: Pregnant patients with cardiac disease have significantly higher predicted maternal morbidity and mortality compared to the general obstetric population. Published guidelines on optimal management of these patients recommend multidisciplinary care provision. There are few published data on the incidence of haematological complications in pregnant women with cardiac disease, although the data that does exist suggests a relatively high rate of bleeding and thrombotic events.
Aims: To determine the outcomes in terms of haematological morbidity occurring within a cohort of pregnant women with cardiac disease in the setting of multidisciplinary care provision.
Methods: Patients were identified from a database compiled by the obstetric cardiology service listing all cardiac patients managed in the Rotunda maternity hospital during the period from 2004 to 2011. Data were obtained from the medical and obstetric case notes relating to details of perinatal care and the occurrence of antenatal and postnatal complications.
Results: During the 8-year review period, 451 women with cardiac disease were assessed. Fifty-nine were determined to have moderate to high-risk disease. Each received consultant-delivered multidisciplinary care, where written management strategies were agreed by collaborating senior colleagues either preconceptually or in early pregnancy. No venous thromboembolic events occurred and a modest rate of post-partum haemorrhage (approximately 5%) was recorded. There were no maternal deaths.
Conclusion: The relatively favourable outcomes observed within our institution highlight the importance of a multidisciplinary approach to the management of pregnant women with cardiac disease, particularly in scenarios where limited published evidence exists to guide management.
Acknowledgments
The authors would like to acknowledge the support of the “Friends of the Rotunda” charity and the Health Research Board of Ireland (Health research award R13728).
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Academy’s Corner
- Obstetrical Doppler: the evidence today
- Review article
- Fetal complications due to intrahepatic cholestasis of pregnancy
- Original articles – Obstetrics
- Pre-pregnancy obesity compromises obstetric and neonatal outcomes
- Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester
- Placental gene expression of inflammatory markers and growth factors – a case control study of obese and normal weight women
- Haemorrhagic and thrombotic complications in pregnant women with acquired and congenital cardiac disease
- Intrapartum ultrasound prior to Kristeller maneuver: an observational study
- Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals
- Use of the angle of progression on ultrasonography to predict spontaneous onset of labor within 7 days
- Study of the relationship in pregnant women between hepatitis B markers and a placenta positive for hepatitis B surface antigen
- Sarcoidosis and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 7 million births
- Original articles – Fetus
- MR imaging of the fetal brain at 1.5T and 3.0T field strengths: comparing specific absorption rate (SAR) and image quality
- Sex differences in the fetal heart rate variability indices of twins
- Original articles – Newborn
- Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study
- Antenatal testing in uncomplicated pregnancies: should testing be initiated after 40 or 41 weeks?
- Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection
- Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival
- The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants
- Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery
- Commentary
- Thrombophilia testing in pregnancy: should we agree to disagree?
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Academy’s Corner
- Obstetrical Doppler: the evidence today
- Review article
- Fetal complications due to intrahepatic cholestasis of pregnancy
- Original articles – Obstetrics
- Pre-pregnancy obesity compromises obstetric and neonatal outcomes
- Novel application of three-dimensional HDlive imaging in prenatal diagnosis from the first trimester
- Placental gene expression of inflammatory markers and growth factors – a case control study of obese and normal weight women
- Haemorrhagic and thrombotic complications in pregnant women with acquired and congenital cardiac disease
- Intrapartum ultrasound prior to Kristeller maneuver: an observational study
- Interinstitutional variations in mode of birth after a previous caesarean section: a cross-sectional study in six German hospitals
- Use of the angle of progression on ultrasonography to predict spontaneous onset of labor within 7 days
- Study of the relationship in pregnant women between hepatitis B markers and a placenta positive for hepatitis B surface antigen
- Sarcoidosis and pregnancy: obstetrical and neonatal outcomes in a population-based cohort of 7 million births
- Original articles – Fetus
- MR imaging of the fetal brain at 1.5T and 3.0T field strengths: comparing specific absorption rate (SAR) and image quality
- Sex differences in the fetal heart rate variability indices of twins
- Original articles – Newborn
- Correlation of neonatal weight with maternal serum levels of pregnancy-associated plasma protein-A during the first trimester of pregnancy: a retrospective study
- Antenatal testing in uncomplicated pregnancies: should testing be initiated after 40 or 41 weeks?
- Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection
- Associated anomalies in congenital diaphragmatic hernia: perinatal characteristics and impact on postnatal survival
- The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants
- Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery
- Commentary
- Thrombophilia testing in pregnancy: should we agree to disagree?
- Congress Calendar
- Congress Calendar
