Cardiac and Pregnancy Outcomes of Pregnant Patients With Congenital Heart Disease According to Risk Classification System

Steiner, Jill M.; Lokken, Erica; Bayley, Elizabeth W.; Pechán, J; Curtin, Anna; Buber, Jonathan; Albright, Catherine M.

doi:10.1016/j.amjcard.2021.08.037

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…reported an overall occurrence of pre‐eclampsia in 9.4% of 262 pregnancies in women with congenital heart disease; however, in contrast to our study, they observed an inverse association between pre‐eclampsia and severity of heart disease, with 22% in mWHO class I, 6.3% in mWHO class II and class II–III, and 4.4% in mWHO classes III and IV. 27 Although small numbers, Steiner et al. suggest that women at a high cardiovascular risk are optimized before pregnancy and benefit from closer surveillance during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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Hypertensive disorders of pregnancy among women with cardiovascular disease in Norway: A historical cohort study

Langen,

Langesæter,

Gunnes

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionWomen with cardiovascular disease may be at increased risk of hypertensive disorders of pregnancy (HDP). We aimed to: (1) Investigate the occurrence of HDP in a cohort of pregnant women with cardiovascular disease and compare it with the occurrence in the general population. (2) Assess the association between maternal cardiovascular risk and risk of HDP.Material and methodsWe reviewed clinical data on a cohort of 901 pregnancies among 708 women with cardiovascular disease who were followed at the National Unit for Pregnancy and Heart Disease and gave birth at Oslo University Hospital between 2003 and 2018. The exposure under study was maternal cardiovascular risk, classified as low, moderate, or high based on a modified classification by the World Health Organization. The main outcome of interest was HDP, which included pre‐eclampsia and gestational hypertension. The proportion of HDP cases in the general population in the same period was extracted from the Medical Birth Registry of Norway. We used logistic regression to estimate crude and adjusted odds ratios (OR) of HDP, with associated 95% confidence intervals (CIs), for women with moderate‐ and high cardiovascular risk compared to women with low risk.ResultsThe occurrence of HDP in the study cohort was 12.1% (95% CI: 10.0%–14.4%) and varied between 8.7% (95% CI: 6.5%–11.3%) in the low‐risk group, 15.7% (95% CI: 11.1%–21.4%) in the moderate‐risk group, and 22.2% (95% CI: 15.1%–30.8%) in the high‐risk group. By contrast, the nationwide occurrence of HDP was 5.1% (95% CI: 5.1%–5.2%). In the study cohort, the proportions of pregnancies with gestational hypertension and pre‐eclampsia were similar (6.3% and 5.8%, respectively). Compared to pregnancies with low cardiovascular risk, the adjusted OR of HDP was 2.04 (95% CI: 1.21–3.44) in the moderate‐risk group and 2.99 (95% CI: 1.73–5.18) in the high‐risk group.ConclusionsThe occurrence of hypertensive disease of pregnancy in the study cohort was more than doubled compared to the general population in Norway. The risk of HDP increased with maternal cardiovascular risk group. We recommend taking into account maternal cardiovascular risk group when assessing risk and prophylaxis of HDP.

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Section: Discussionmentioning

confidence: 99%

“…27 Although small numbers, Steiner et al suggest that women at a high cardiovascular risk are optimized before pregnancy and benefit from closer surveillance during pregnancy.…”

mentioning

confidence: 99%

Hypertensive disorders of pregnancy among women with cardiovascular disease in Norway: A historical cohort study

Langen,

Langesæter,

Gunnes

et al. 2024

Acta Obstet Gynecol Scand

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“…Upon reviewing different literatures, we identified the specific risks in pregnancy related to different hemodynamic conditions produced by heart defects[ 15 - 17 ]. There was no difference in obstetric complications between pregnant women with unrepaired and repaired ASD.…”

Section: Discussionmentioning

confidence: 99%

Twin pregnancy with sudden heart failure and pulmonary hypertension after atrial septal defect repair: A case report

Tong,

Meng

2023

World J Clin Cases

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BACKGROUND Pulmonary arterial hypertension (PAH) in pregnancy is one of the major obstetric complications and is considered a contraindication to pregnancy as it is classified as a class IV risk in the revised risk classification of pregnancy by the World Health Organisation. Pregnancy, with its adaptive and expectant mechanical and hormonal changes, negatively affects the cardiopulmonary circulation in pregnant women. Do patients with repaired simple congenital heart disease (CHD) develop other pulmonary and cardiac complications during pregnancy? Can pregnant women with sudden pulmonary hypertension be treated and managed in time? In this paper, we present a case of a 39-year-old woman who underwent cesarean section at 33 wk' gestation and developed PAH secondary to repaired simple CHD. Our research began by a PubMed search for "pulmonary hypertension" and "pregnancy" and "CHD" case reports. Three cases were selected to review PAH in pregnancy after correction of CHD defects. These studies were reviewed, coupled with our own clinical experience. CASE SUMMARY Herein, a case involving a woman who underwent atrial septal defect repair at the age of 34, became pregnant five years later, and had a sudden onset of PAH and right heart failure secondary to symptoms of acute peripheral edema in the third trimester of her pregnancy. As a result, the patient underwent a cesarean section and gave birth to healthy twins. Within three days after cesarean delivery, her cardiac function deteriorated as the pulmonary artery pressure increased. Effective postpartum management, including diuresis, significant oxygen uptake, vasodilators, capacity and anticoagulants management, led to improvements in cardiac function and oxygenation. The patient was discharged from hospital with a stable recovery and transferred to local hospitals for further PAH treatment. CONCLUSION This case served as a reminder to obstetricians of the importance of pregnancy after repair of CHD. It is crucial for patients with CHD to receive early correction. It suggests doctors should not ignore edema of twin pregnancy. Also, it provides a reference for the further standardization of antenatal, intrapartum and postpartum management for patients with CHD worldwide.

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“…The prediction of Coronary Disease and to increase the precision of predicting the disease using novel Random Forest and comparing it with Logistic Regression. In the course of the last 10 years, coronary disease or cardiovascular sickness remains the essential premise of death around the world (Steiner et al 2021). An estimation by means of the World wellbeing association, that over 17.9 million passouts happen each overall year due to cardiovascular disorders, mainly 80% of the passouts are only in view of coronary vein infection also, cerebral stroke (Woodruff et al 2021).…”

Section: Introductionmentioning

confidence: 99%

Classification and Prediction of Heart Disease using Novel Random Forest Algorithm by Comparing Logistic Regression for Obtaining Better Accuracy

Poojitha¹,

Mahaveerakannan²

2023

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Aim: Heart attacks are usually caused due to blockages, partially or completely, of the heart’s veins or arteries that constrict the flow of blood from or to the heart. The primary objective of this review aims to be seen as the most appropriate algorithm to give us the ideal prediction. We will be comparing the novel Random forest with Logistic regression to find out which of these can give us the best accuracy. Material and Methods: The study used 143 samples with novel Random Forest and Logistic Regression is executed with varying training and testing splits for foreseeing the accuracy of coronary disease prediction with the 80% of G-power value and heart disease data were gathered from multiple web sources, including latest The study’s findings and criterion were 0.05%, with a 95% probability value, average, and confidence interval. The performance accuracy rate of the classifiers is used to evaluate the coronary disease dataset. There was a statistically significant value test between the novel Random Forest and Logistic Regression is 0.046 (p<0.05). Results and Discussion: The accuracy of predicting coronary disease in the novel Random Forest 90.16 % and Logistic Regression 85.25 % is obtained. Conclusion: This study concludes that the Prediction of Coronary disease using the novel Random Forest (RF) algorithm looks to be fundamentally superior to the Logistic Regression (LR) with increased precision.

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Cardiac and Pregnancy Outcomes of Pregnant Patients With Congenital Heart Disease According to Risk Classification System

Cited by 11 publications

References 13 publications

Hypertensive disorders of pregnancy among women with cardiovascular disease in Norway: A historical cohort study

Hypertensive disorders of pregnancy among women with cardiovascular disease in Norway: A historical cohort study

Twin pregnancy with sudden heart failure and pulmonary hypertension after atrial septal defect repair: A case report

Classification and Prediction of Heart Disease using Novel Random Forest Algorithm by Comparing Logistic Regression for Obtaining Better Accuracy

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