Clinical analyses of 383 cases with maternal cardiac diseases
-
Emine Aydin
,
Ozgur Ozyuncu
Abstract
Aim:
To evaluate the pregnancy outcomes of women with heart disease.
Materials and methods:
In this retrospective study, 383 pregnant women with cardiac diseases were examined. The cases were classified according to the World Health Organization (WHO) classification. The distribution of the cases according to class, congenital heart diseases, mean birthweight, mean gestational week at delivery, type of delivery [cesarean section (CS) or vaginal delivery], and cardivascular events (during pregnancy and puerperium) were evaluated.
Results:
Of the 383 patients, 25 were in Class I; 39, Class II; 255, Class II or III; 31, Class III; and 33, Class IV cardiac diseases. The neonatal birth weights were significantly lower in Class III than in Classes II, and II or III. The preterm delivery rate was higher in Class III than in the other classes. Delivery was performed by CS due to cardiac indications in the high-risk classes, however, only obstetric indications were considered in the low-risk classes. Only one case of maternal death occurred during the postpartum period, in a patient with Eisenmenger’s syndrome.
Discussion:
Cardiovascular diseases are an important cause of mortality and morbidity in pregnancy. The adverse impact of cardiovascular disorders on pregnancy outcomes should be the main concern during the management of these women.
Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.
References
[1] Creanga AA, Berg CJ, Syverson C, Seed K, Bruce FC, Callaghan WM. Pregnancy-related mortality in the United States, 2006–2010. Obstet Gynecol. 2015;125:5–12.10.1097/AOG.0000000000000564Suche in Google Scholar
[2] Chapman AB, Abraham WT, Zamudio S, Coffin C, Merouani A, Young D, et al. Temporal relationships between hormonal and hemodynamic changes in early human pregnancy. Kidney Int. 1998;54:2056–63.10.1046/j.1523-1755.1998.00217.xSuche in Google Scholar
[3] Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC, et al. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation. 2001;104:515–21.10.1161/hc3001.093437Suche in Google Scholar
[4] Yap SC, Drenthen W, Pieper PG, Moons P, Mulder BJ, Vliegen HW, et al. Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect. Br J Obstet Gynecol. 2010;117:683–9.10.1111/j.1471-0528.2010.02512.xSuche in Google Scholar
[5] European Society of G, Association for European Paediatric C, German Society for Gender M, Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:3147–97.10.1093/eurheartj/ehr218Suche in Google Scholar
[6] Senatore SDS, Andreozzi S. Study on causes of maternal mortality and morbidity and development of surveillance models of maternal mortality: Istituto Superiore di Sanita; 2012. Report No.: 1643.Suche in Google Scholar
[7] Weiss BM, von Segesser LK, Alon E, Seifert B, Turina MI. Outcome of cardiovascular surgery and pregnancy: a systematic review of the period 1984–1996. Am J Obstet Gynecol. 1998;179(6 Pt 1):1643–53.10.1016/S0002-9378(98)70039-0Suche in Google Scholar
[8] Curtis SL, Marsden-Williams J, Sullivan C, Sellers SM, Trinder J, Scrutton M, et al. Current trends in the management of heart disease in pregnancy. Int J Cardiol. 2009;133:62–9.10.1016/j.ijcard.2007.11.084Suche in Google Scholar
[9] Uygur D, Beksac MS. Mitral balloon valvuloplasty during pregnancy in developing countries. Eur J Obstet Gynecol Reprod Biol. 2001;96:226–8.10.1016/S0301-2115(00)00458-9Suche in Google Scholar
[10] Khairy P, Ouyang DW, Fernandes SM, Lee-Parritz A, Economy KE, Landzberg MJ. Pregnancy outcomes in women with congenital heart disease. Circulation. 2006;113:517–24.10.1161/CIRCULATIONAHA.105.589655Suche in Google Scholar PubMed
[11] Drenthen W, Boersma E, Balci A, Moons P, Roos-Hesselink JW, Mulder BJ, et al. Predictors of pregnancy complications in women with congenital heart disease. Eur Heart J. 2010;31:2124–32.10.1093/eurheartj/ehq200Suche in Google Scholar PubMed
[12] Siu SC, Colman JM, Sorensen S, Smallhorn JF, Farine D, Amankwah KS, et al. Adverse neonatal and cardiac outcomes are more common in pregnant women with cardiac disease. Circulation. 2002;105:2179–84.10.1161/01.CIR.0000015699.48605.08Suche in Google Scholar
[13] Siu SC, Colman JM. Heart disease and pregnancy. Heart. 2001;85:710–5.10.1002/9780470986882.ch60Suche in Google Scholar
[14] Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, et al. Cardiac disease in pregnancy. Int J Gynaecol Obstet. 2003;82:153–9.10.1016/S0020-7292(03)00159-0Suche in Google Scholar
[15] Uebing A, Arvanitis P, Li W, Diller GP, Babu-Narayan SV, Okonko D, et al. Effect of pregnancy on clinical status and ventricular function in women with heart disease. Int J Cardiol. 2010;139:50–9.10.1016/j.ijcard.2008.09.001Suche in Google Scholar PubMed
[16] Leary PJ, Leary SE, Stout KK, Schwartz SM, Easterling TR. Maternal, perinatal, and postneonatal outcomes in women with chronic heart disease in Washington State. Obstet Gynecol. 2012;120:1283–90.10.1097/AOG.0b013e3182733d56Suche in Google Scholar
[17] Stangl V, Schad J, Gossing G, Borges A, Baumann G, Stangl K. Maternal heart disease and pregnancy outcome: a single-centre experience. Eur J Heart Fail. 2008;10:855–60.10.1016/j.ejheart.2008.07.017Suche in Google Scholar PubMed
[18] Wacker-Gussmann A, Thriemer M, Yigitbasi M, Berger F, Nagdyman N. Women with congenital heart disease: long-term outcomes after pregnancy. Clin Res Cardiol. 2013;102:215–22.10.1007/s00392-012-0522-5Suche in Google Scholar PubMed
[19] Elkayam U, Goland S, Pieper PG, Silverside CK. High-risk cardiac disease in pregnancy: part II. J Am Coll Cardiol. 2016;68:502–16.10.1016/j.jacc.2016.05.050Suche in Google Scholar PubMed
[20] Elkayam U, Goland S, Pieper PG, Silverside CK. High-risk cardiac disease in pregnancy: part I. J Am Coll Cardiol. 2016;68:396–410.10.1016/j.jacc.2016.05.048Suche in Google Scholar PubMed
[21] Abdel-Hady ES, El-Shamy M, El-Rifai AA, Goda H, Abdel-Samad A, Moussa S. Maternal and perinatal outcome of pregnancies complicated by cardiac disease. Int J Gynaecol Obstet. 2005;90:21–5.10.1016/j.ijgo.2005.03.008Suche in Google Scholar PubMed
[22] Alonso-Gonzalez R, Swan L. Treating cardiac disease in pregnancy. Womens Health (Lond). 2014;10:79–88; quiz 9–90.10.2217/WHE.13.70Suche in Google Scholar
©2018 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Editorial
- Corner of Academy
- Peripartum cardiomyopathy – from pathogenesis to treatment
- Original articles – Obstetrics
- Is forty the new thirty? Population based study of advanced maternal age
- The laboratory control of anticoagulant thromboprophylaxis during the early postpartum period after cesarean delivery
- Epidural analgesia at trial of labor after cesarean (TOLAC): a significant adjunct to successful vaginal birth after cesarean (VBAC)
- Postpartum infection in relation to maternal characteristics, obstetric interventions and complications
- A technological advance for 21st century obstetricians: the electronically-controlled vacuum extractor
- Five years’ experience in an anesthesiology antenatal clinic for high-risk patients
- Clinical analyses of 383 cases with maternal cardiac diseases
- Induction of labor in patients with an unfavorable cervix after a cesarean using an osmotic dilator versus vaginal prostaglandin
- The misoprostol vaginal insert compared with oral misoprostol for labor induction in term pregnancies: a pair-matched case-control study
- Adiponectin concentration in mid-trimester amniotic fluid varies with the α-amylase level and maternal and neonatal outcomes
- Placental examination in nonmacerated stillbirth versus neonatal mortality
- Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation: a nationwide, population-based record linkage study
- An observation of umbilical coiling index in a low risk population in Nigeria
Artikel in diesem Heft
- Frontmatter
- Editorial
- Editorial
- Corner of Academy
- Peripartum cardiomyopathy – from pathogenesis to treatment
- Original articles – Obstetrics
- Is forty the new thirty? Population based study of advanced maternal age
- The laboratory control of anticoagulant thromboprophylaxis during the early postpartum period after cesarean delivery
- Epidural analgesia at trial of labor after cesarean (TOLAC): a significant adjunct to successful vaginal birth after cesarean (VBAC)
- Postpartum infection in relation to maternal characteristics, obstetric interventions and complications
- A technological advance for 21st century obstetricians: the electronically-controlled vacuum extractor
- Five years’ experience in an anesthesiology antenatal clinic for high-risk patients
- Clinical analyses of 383 cases with maternal cardiac diseases
- Induction of labor in patients with an unfavorable cervix after a cesarean using an osmotic dilator versus vaginal prostaglandin
- The misoprostol vaginal insert compared with oral misoprostol for labor induction in term pregnancies: a pair-matched case-control study
- Adiponectin concentration in mid-trimester amniotic fluid varies with the α-amylase level and maternal and neonatal outcomes
- Placental examination in nonmacerated stillbirth versus neonatal mortality
- Neurodevelopmental outcome at the age of 4 years according to the planned mode of delivery in term breech presentation: a nationwide, population-based record linkage study
- An observation of umbilical coiling index in a low risk population in Nigeria
