A single-center experience with 12 consecutive cases of pregnancy among patients with membranous ventricular septal aneurysm

Abstract

BackgroundMembranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center’s experience.MethodsThis was a retrospective study for consecutive 12 pregnancies in women with MVSA, who delivered at a tertiary care center in west China between May 2008 and March 2015.ResultsAll patients with MVSA delivered via caesarian section. One patient with severe pulmonary arterial hypertension expired from pulmonary infection and heart failure after delivery. One patient terminated pregnancy in the second trimester- necessitated by cardiogenic shock. The other mothers had varying degrees of cardiac morbidity, but survived. Ten of thirteen newborns survived. Congenital heart disease and small-for-gestational-age (SGA) of newborn occurred in two cases (one twin and one single gestation). Two of these babies expired.ConclusionsMaternal and neonatal risk appeared associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmia. Accurate diagnosis and care by a multidisciplinary team is recommended for pregnant woman with MVSA.

Pregnancy outcomes among 31 patients with tetralogy of Fallot

“…In consideration of high complication risks, woman with cardiac disease may be safer with a C-section delivery to avoid prolonged laboring time [22]. In this study, one patient with intrauterine fetal death undergone transvaginal complete curettage of uterine cavity, other uncorrected patients delivered by C-section successfully.…”

Pregnancy outcomes among 31 patients with tetralogy of Fallot

“…The mean birth weight centile was significantly lower, and the small for gestational age was a common occurrence (41.67%) in pregnancy women with unrepaired TOF. In consideration of high complication risks, woman with cardiac disease may be safer with a cesarean section delivery to avoid prolonged labor or any pushing [21].In this study, one patient with intrauterine fetal death undergone transvaginal complete curettage of uterine cavity, other uncorrected patients delivered by cesarean section under combined spinal epidural anesthesia, epidural anesthesia or general anesthesia. We assumed that the successful outcomes resulted from the absence of thromboembolism, severe hypertension, and cardiac failure.…”

Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study

“…In consideration of high complication risks, woman with cardiac disease may be safer with a C-section delivery to avoid prolonged laboring time [21]. In this study, one patient with intrauterine fetal death undergone transvaginal complete curettage of uterine cavity, other uncorrected patients delivered by C-section successfully.…”