Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus.

Abstract

In a series of 416 women with congenital heart disease seen in the Royal Brompton National Heart and Lung Hospital, London, and the Hospital Giovanni Bosco, Torino, Italy, there were 822 pregnancies. The outcomes of 96 pregnancies in 44 patients with cyanotic congenital heart disease were studied. Patients with the Eisenmenger reaction were excluded. Patients were divided arbitrarily into groups according to the type of maternal congenital cardiac anomaly, and factors influencing maternal and fetal outcome were evaluated. The incidence of maternal cardiovascular complications was high (32%), with one death from endocarditis 2 months after delivery. Forty-one (43%) of 96 pregnancies resulted in a live birth; 15 (37%) were premature. Mean weight of full-term infants was 2575 g. Univariate analysis suggested that maternal disease, Ability Index, hemoglobin, and arterial oxygen saturation before the pregnancy were factors that discriminated between successful and unsuccessful fetal outcome, with hemoglobin and arterial oxygen saturation being the most important predictors. Women with cyanotic congenital heart disease can go through pregnancy with a low risk to themselves, with frequent treatable complications, but there is a high incidence of miscarriage, premature births, and low birth weights. An incidence of congenital heart disease in the fetus of 4.9% (2 of 41 live births) is higher than that found in the normal population.

A 25-Year-Old Pregnant Lady with Heart Disease

“…5 Management of heart disease in pregnancy depends on early diagnosis, evaluation of functional grade, detection of high risk factors and prevention of cardiac failure. 6 Obstetrician with the help of cardiologist should care the patient and hospital delivery is mandatory. If needed prophylactic antibiotics and anticoagulant should be used.…”

A Case of Abdominal Pain, Hypoxia and Clubbing

“…Complications from untreated cyanotic congenital heart disease include erythrocytosis, problems with hemostasis, hyperuricemia, renal dysfunction, cerebrovascular accidents, endocarditis, brain abscesses, supraventricular and ventricular arrhythmias, and the development of Eisenmenger's Syndrome [3,[5][6][7][8]. Female patients may experience a delay in menarche or menorrhagia and if they chose to become pregnant, pregnancies may result in a high incidence of miscarriage, premature births or low birth weight babies [9,10]. If not repaired, the 2008 ACC/AHA guidelines recommend prophylaxis for the prevention of endocarditis and the avoidance of competitive sports [5].…”

Role of Echocardiography in Assessing Pregnant Women With and Without Heart Disease

“…In one study of 96 pregnancies in 44 patients with cyanotic heart diseases, maternal cardiac complications were seen in 32%, and the rate of live births was 43%. Hemoglobin 16g/dL and oxygen saturation 85% were found to be prognosticators [18].…”