Outcome of pregnancy in patients after repair of aortic coarctation

Abstract

Pregnancy is well tolerated in women after repair of aortic coarctation. However, an excess of miscarriages and hypertensive disorders of pregnancy were found.

Pregnancy, Genetic Risk and Congenital Heart Disease

“…Overall, there was an excess of miscarriages and hypertensive disorders of pregnancy. (40) Coarctation is the only CHD known to be an independent predictor of pre-eclampsia.…”

Cardiovascular Management in Pregnancy

“…There is a small risk of aortic dissection in both unoperated and postoperative patients as well as an increased risk of preeclampsia and hypertension. 29,70,71 Using a national database of hospitalizations, a study by Krieger et al 72 demonstrated that women with coarctation of the aorta have a higher risk of hypertensive complications during pregnancy (including preexisting hypertension, pregnancy-induced hypertension, preeclampsia, and eclampsia), a higher risk of adverse cardiovascular outcomes (including heart failure, arrhythmia, stroke, and other embolic events), a higher risk of Caesarean section, increased hospital stays, and higher hospital costs. Aggressive blood pressure control in mothers with unrepaired coarctation may result in decreased uterine blood flow with compromise of fetal growth.…”

“…Aggressive blood pressure control in mothers with unrepaired coarctation may result in decreased uterine blood flow with compromise of fetal growth. 29,70,71 The ESC guidelines suggest an increased risk of aortic rupture and rupture of intracerebral aneurysms in mothers with unrepaired coarctation and in mothers with previous repair who remained hypertensive. 21 Adult patients may have undergone previous intervention with either surgery or catheter intervention.…”

Effect of maternal heart disease on pregnancy outcomes

“…By contrast, native coarctation is encountered much less frequently. Pregnancy is usually well tolerated in adequately repaired coarctation [53]. It is essential to assess cardiac status prior to conception, excluding and appropriately managing complications such as recoarctation, aneurysm at the site of repair, an associated bicuspid aortic valve or systemic hypertension.…”