Association of Adult Congenital Heart Disease With Pregnancy, Maternal, and Neonatal Outcomes

Ramage, Kaylee; Grabowska, Kirsten; Silversides, Candice; Quan, Hude; Metcalfe, Amy

doi:10.1001/jamanetworkopen.2019.3667

“…Pregnant women with TOF were at high risk for maternal and neonatal complications as other types of heart disease, involving miscarriage, prematurity, premature rupture of membranes (PROM), preeclampsia, breech presentation, postpartum hemorrhage for the mothers; and small for gestational age, low birth weights, and cardiac anomalies for the newborns [4,18].Recently Ramage et al reported 2114 births to women with ACHD ( adult congenital heart disease) and suggested an association between several adverse neonatal and maternal outcomes and ACHD [19].They results showed that preterm births (<37 weeks gestation) were associated with 1.4 times higher odds among women with ACHD compared with those without ACHD.Women with ACHD also had higher odds of having a preterm birth at less than 32 weeks'gestation. Almost 12.8% of women with ACHD delivered an SGA infant compared with 8.7% of women without ACHD.…”

Section: Discussionmentioning

confidence: 99%

“…Although one case suffered with hypertension and cardiac failure, she was survived with professional care. Women at highest risk can benefit from preconception counseling and close clinical monitoring during pregnancy [19]. Careful interdisciplinary management among the cardiologist, obstetrician, anesthetist, and neonatologist, and detailed plans for delivery may have improved the prognosis [22].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes among 31 patients with tetralogy of Fallot

Wang

¹

,

Xin

²

,

Wang

³

et al. 2019

Preprint

0

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Background Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied.Methods Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed.Results A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias.Conclusions Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.

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“…Recently Ramage et al reported 2114 births to women with adult congenital heart disease (ACHD) and suggested an association between several adverse neonatal and maternal outcomes and ACHD [20]. They results showed that preterm births (<37 weeks gestation) were associated with 1.4 times higher odds among women with ACHD compared with those without ACHD.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, one patient with intrauterine fetal death undergone transvaginal complete curettage of uterine cavity, other uncorrected patients delivered by C-section successfully. Women at highest risk can benefit from preconception counseling and close clinical monitoring during pregnancy [20]. Careful interdisciplinary management among the cardiologist, obstetrician, anesthetist, and neonatologist, and detailed plans for delivery may have improved the prognosis [23].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study

Wang

¹

,

Xin

²

,

Wang

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied.Methods Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed.Results A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias.Conclusions Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.

show abstract

“…Recently Ramage et al reported 2114 births to women with adult congenital heart disease (ACHD) and suggested an association between several adverse neonatal/maternal outcomes and ACHD [20].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy outcomes among 31 patients with tetralogy of Fallot

Wang

¹

,

Xin

²

,

Wang

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied.Methods Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed.Results A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias.Conclusions Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.

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Association of Adult Congenital Heart Disease With Pregnancy, Maternal, and Neonatal Outcomes

Cited by 78 publications

References 44 publications

Pregnancy outcomes among 31 patients with tetralogy of Fallot

Pregnancy outcomes among 31 patients with tetralogy of Fallot

Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study

Pregnancy outcomes among 31 patients with tetralogy of Fallot

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