Pregnancy still contraindicated in pulmonary arterial hypertension related to congenital heart disease: True or false?

Ntiloudi, Despοina; Giannakoulas, George

doi:10.1177/2047487318825347

Cited by 7 publications

(3 citation statements)

References 15 publications

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“…The adopted phenomenological methodology is pivotal for starting to bridge this knowledge gap and for supporting healthcare providers in the design, test and implementation of specific intervention programme. In fact, our results contribute to the understanding of the little-known challenges endured by women with CHD who desire and have experienced pregnancy despite the high risks and complications caused by their illness 29. Results of this study could be pivotal for cultivating a tailored and theory-grounded healthcare delivery system for the mothers with CHD as well as for their children and whole family.…”

Section: Discussionmentioning

confidence: 69%

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

et al. 2020

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ObjectiveThis study explored the lived experiences of women with congenital heart disease (CHD) during pregnancy and early motherhood.DesignQualitative study using semistructured interviews. Data were analysed according to interpretative phenomenological analysis.SettingSan Donato Milanese, Italy.Participants12 adult women during pregnancy or early motherhood.ResultsThree main themes emerged from the analysis that were labelled as follows: ‘Being a woman with CHD’; ‘Being a mother with CHD’; and ‘Don’t be alone’. Mothers described both positive and negative feelings about their pregnancies and transitions from childless women to mothers with CHD. They needed supportive care to improve the management of their health during pregnancy and early motherhood.ConclusionThis study explored the lived experiences of women with CHD during pregnancy and early motherhood. The emerged themes represent an initial framework for implementing theory-grounded educational and supportive strategies that improve self-care, engagement and quality of life for women with CHD. Furthermore, the study’s results provide guidance for operationalising the described experiences into items and domains for future cross-national surveys.

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Section: Discussionmentioning

confidence: 69%

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

et al. 2020

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“…This may lead to fetal growth restriction, distress, and even death. Hence, the incidence of induced abortion, preterm delivery, and low birth weight infants has increased significantly [ 54 ]. In terms of birth weight, gestational age, premature delivery, the incidence of small for gestational age, low birth weight, neonatal asphyxia, and neonatal mortality, the moderate to severe pulmonary hypertension group performed significantly worse than the mild group.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy feasibility in women with mild pulmonary arterial hypertension: a systematic review and meta-analysis

Gao

Cui

et al. 2023

BMC Pregnancy Childbirth

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Background The aim of this study was to evaluate the pregnancy feasibility of women with mild pulmonary hypertension according to pregnancy outcomes. Methods This systematic review and meta-analysis compared the differences in maternal and fetal outcomes between mild and moderate-to-severe pulmonary hypertension. Relevant English and Chinese literature were searched in the PubMed, Embase, Cochrane Central Register of Controlled Trials (COCHRANE), CNKI, WanFang Data, and VIP databases between January 1st, 1990 and April 18th, 2023, and the references of the included articles and relevant systematic reviews were reviewed to determine whether studies were missed. The inclusion criteria were randomized controlled and observational studies (including case-control studies and cohort studies) examining maternal and fetal pregnancy outcomes with pulmonary hypertension. Conference abstracts, case reports, case series reports, non-comparative studies, and review articles were excluded. Results This meta-analysis included 32 studies. In this study, maternal and fetal outcomes were better in the mild pulmonary hypertension group than in the moderate-to-severe group. Regarding maternal mortality, the mild group was much lower than the moderate to severe group. We found a significant decrease in maternal mortality in the mild group after 2010. However, no significant difference in maternal mortality before and after 2010 was observed in the moderate to severe group. Cardiac complications, ICU admission, neonatal preterm birth, small for gestational age infants, low birth weight infants, neonatal asphyxia, and neonatal mortality were significantly lower in the mild pulmonary hypertension group than in the moderate to severe pulmonary hypertension group. The cesarean section rates of the two groups were similar. However, the vaginal delivery rate in the mild pulmonary hypertension group was significantly higher than that in the moderate to severe pulmonary hypertension group. Conclusions This meta-analysis confirmed that pregnancies with mild pulmonary hypertension had significantly better maternal and fetal outcomes than those with moderate to severe pulmonary hypertension. For patients with mild pulmonary hypertension and good cardiac function, continued pregnancy or even delivery should be considered under multidisciplinary monitoring. However, maternal and fetal complications with moderate to severe pulmonary hypertension significantly increase. Hence, it is essential to evaluate pregnancy risk and terminate it in time.

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“…Despite their health condition (Ntiloudi & Giannakoulas, 2019 ), the willingness to be a mother can provide CHD women with strong motivation to face their illness (Vallido et al, 2010 ), and with the chance to demonstrate that they do not have less chance to lead a normal life (LaPierre et al, 2017 ). However, upon reaching child‐bearing age, CHD women must receive support and counselling to be prepared to bear a pregnancy (Vallido et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators of experiencing pregnancy and motherhood with congenital heart disease: A secondary qualitative analysis

et al. 2022

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Congenital heart disease (CHD) represents one of the most important health challenges, affecting approximately from 3% to 10% of live births (Bouma & Mulder, 2017) and representing 0.8%-1.2% of all congenital birth defects (Marelli et al., 2007). The life expectancy of patients with CHD has deeply changed over the past decades, thanks to the progress in diagnosis, the refinement of percutaneous and surgical interventions and devices, the discovery of biomarkers and clinical research (Bouma & Mulder, 2017;Engelfriet et al., 2005).More than 85% of CHD children currently reach adulthood (Giamberti et al., 2016). Accordingly, a transition from childhood to adulthood has become a reality for most patients (Flocco et al., 2018(Flocco et al., , 2019, resulting in a new CHD adult population (Dellafiore et al., 2019).Currently, the percentage of CHD women who are becoming pregnant is increasing worldwide (Opotowsky et al., 2012), and pregnancy and motherhood constitute a challenge for these women due to the high risk of complications associated with the complexity of

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Pregnancy still contraindicated in pulmonary arterial hypertension related to congenital heart disease: True or false?

Cited by 7 publications

References 15 publications

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

Exploring the lived experiences of pregnancy and early motherhood in Italian women with congenital heart disease: an interpretative phenomenological analysis

Pregnancy feasibility in women with mild pulmonary arterial hypertension: a systematic review and meta-analysis

Barriers and facilitators of experiencing pregnancy and motherhood with congenital heart disease: A secondary qualitative analysis

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