Outcome of pregnancy in women with congenital shunt lesions

Züber, Michel; Gautschi, N; Oechslin, Erwin; Widmer, Verena; Kiowski, Wolfgang; Jenni, Rolf

doi:10.1136/hrt.81.3.271

Cited by 88 publications

(59 citation statements)

References 22 publications

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“…3,4 In the present study we found a low rate of cardiac events during pregnancy, which is in agreement with the small amount of existing literature. [5][6][7][8] The risk of obstetric events was associated with the corrective status. The presence of an unrepaired VSD was associated with a higher risk of pre-eclampsia (8.7%).…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Despite the fact that a VSD is one of the most common forms of heart disease among pregnant women, VSD-specific pregnancy data are limited. [5][6][7][8] A recent literature review of studies published between 1985 and 2007 found a total of 83 completed pregnancies among women with VSDs (combining repaired and unrepaired VSD). 9 The current consensus is that pregnancy in women with an isolated VSD is generally well tolerated, with no maternal mortality and no significant maternal or fetal morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

Yap

Drenthen

Pieper

et al. 2010

BJOG

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Objective To compare the risks of pregnancy complications in women with repaired and unrepaired isolated ventricular septal defect (VSD).Design A retrospective multicentre study.Setting Tertiary centres in the Netherlands and Belgium.Methods Women were identified using two congenital heart disease registries. Eighty-eight women were identified who had experienced 202 pregnancies, including 46 miscarriages and nine terminations of pregnancy. Information on each completed pregnancy (n = 147; unrepaired VSD, n = 104; repaired VSD, n = 43) was obtained using medical records and telephone interviews. Data from the Generation R database (prospective cohort study; n = 9667) were used to determine the background risk (controls). Odds ratios and 95% CI were estimated using general estimation equation analysis adjusted for multiple pregnancies per woman, maternal age and parity status.Main outcome measures Adjusted odds ratios (AORs) for developing pregnancy complications in relation to corrective status.Results Pregnancies in women with an unrepaired VSD were associated with a higher risk of pre-eclampsia (AOR 4.59, 95% CI 2.01-10.5, P < 0.001) compared with controls. No differences were observed when comparing women with repaired VSD and controls. Pregnancies in women with repaired VSD were associated with a higher risk of premature labour (AOR 4.02, 95% CI 1.12-14.4, P = 0.03) and small-for-gestational-age (SGA) births (AOR 4.09, 95% CI 1.27-13.2, P = 0.02) compared with women with unrepaired VSD.Conclusions Women with unrepaired VSD are at increased risk of pre-eclampsia, which suggests that it is not a benign condition. In addition, women with repaired VSD are at increased risk of premature labour and SGA births compared with women with unrepaired VSD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

Yap

Drenthen

Pieper

et al. 2010

BJOG

View full text Add to dashboard Cite

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“…Fetal outcome is also good in rheumatic heart disease but in cyanotic heart disease there is increased fetal loss. 9 With improved medical care, surgical correction of congenital lesion and better obstetrical care, maternal and fetal mortality and morbidity have been reduced markedly.…”

Section: Discussionmentioning

confidence: 99%

A 25-Year-Old Pregnant Lady with Heart Disease

Khatun¹

2017

J Enam Med Col

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“…(25)(26)(27) Mitral valve prolapse is no contraindication for pregnancy. (27) Medium or high-risk pregnancy includes women with 1) prosthetic valves; 2) obstructive lesions, including uncorrected coarctation of the aorta; 3) Marfan syndrome or other aortic disorders; 4) cyanotic CHD; 5) pulmonary hypertension; 6) systemic ventricular dysfunction (ejection fraction <40%), or 7) signifi cant uncorrected CHD (see Table II).…”

Section: Principles Of Management Of Pregnancy In Women With Chdmentioning

confidence: 99%

Pregnancy, Genetic Risk and Congenital Heart Disease

Jost

Connolly

2017

SAHJ

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An increasing number of women with congenital heart disease (CHD) are reaching childbearing age and are considering pregnancy. Pregnancy is tolerated well in most of these women with unoperated, or repaired cardiac lesions; however, the risk is increased considerably in certain situations such as pulmonary hypertension, severe valvular stenosis, pulmonary atresia, mechanical prosthetic valves, with Fontan type circulation, in Marfan syndrome and other aortopathy. Counseling prior to pregnancy in CHD also involves discussion of genetic testing, possibility of transmission to the child, management during pregnancy including preimplantation genetic testing, and recommendations regarding fetal echocardiography. All medications including anticoagulation options if needed should be carefully reviewed prior to pregnancy due to maternal and fetal risks. If needed, cardiac surgery or balloon valvuloplasty can be carried out with an increased risk to mother and fetus. Overall, pregnancy in CHD is feasible in most patients with good maternal and fetal outcome. High risk pregnancy patients with CHD have to be counseled by a multidisciplinary team including cardiologists, obstetricians and anesthesiologists at a tertiary care center. ABSTRACT PREGNANCY AND CONGENITAL HEART DISEASE

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Outcome of pregnancy in women with congenital shunt lesions

Cited by 88 publications

References 22 publications

Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

A 25-Year-Old Pregnant Lady with Heart Disease

Pregnancy, Genetic Risk and Congenital Heart Disease

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