Avaliação de fatores de risco para o desenvolvimento de complicações perinatais na presença de cardiopatia materna

Risk Prediction of Cardiovascular Complications in Pregnant Women With Heart Disease

“…This study shows that the population of pregnant women with heart disease cared for at our institution did not change much in the past 17 years regarding etiology. Over half of this population (62%) had rheumatic heart disease, a percentage similar to that obtained by Bacha et al 7 (56.8%) from 1990 to 1995. That percentage was also close to the one reported by Ávila et al 8 when following 1,000 patients up at Incor during a similar period.…”

“…The present study describes the profile of a population of pregnant women with heart disease, mainly rheumatic lesions, which are usual in the Brazilian population. A 22.72% prevalence of cardiovascular complications in pregnancy was found, a rate close to those found in this same institution in 1997 7 and at the Instituto do Coração (Incor) of the Medical School of the São Paulo University, 8 23.9% and 23.5%, respectively. The most recent international studies have revealed a lower number of complications: a Canadian study has reported 13% of complications; 4 the ZAHARA I study, conducted in Holland in 2010, 5 reported a 7.6% incidence; and, even more recently, in 2013, an European collaborative study reported 10% of cardiovascular complications.…”

“…Regarding the presence of advanced functional class at the beginning of pregnancy, all studies, regardless of the population studied, indicate that variable as a risk predictor, similarly to that observed in our population. Since the studies by Bacha et al, 7 that association of maternal complications has been reported in the presence of a baseline NYHA classification III or IV at the beginning of the prenatal care or when the pregnant woman has pulmonary hipertension. 2 , 4 , 8 , 12 …”

“… 4 - 6 However, only a few Brazilian studies have assessed them. 7 The present study had the following objectives: to establish the prevalence and etiology of heart diseases in pregnant women cared for at our referral center; to identify the most frequent maternal complications and their repercussions on maternal and perinatal outcomes; and to assess the risk predictors of cardiac complications that may influence maternal-fetal outcomes.…”

Posicionamento da Sociedade Brasileira de Cardiologia para Gravidez e Planejamento Familiar na Mulher Portadora de Cardiopatia – 2020

“…Maternal clinical complications associated with low cardiac output lead to a greater frequency of low birth weight -, with an average weight 300 g lower when compared to pregnancies that progressed without complications -and Apgar score less than 7. 21 Maternal hypoxemia in women with cyanotic heart disease increases fetal risk, even though there is a compensation mechanism to facilitate fetal oxygen delivery. Most newborns with maternal hypoxemia are small for gestational age and premature.…”