Pregnancy outcome in women with congenital heart disease: A single-center experience

Ntiloudi, Despina; Zegkos, Thomas; Bazmpani, Maria Anna; Parcharidou, Despοina; Panagiotidis, Theofilos; Hadjimiltiades, Stavros; Karvounis, Haralambos; Giannakoulas, George

doi:10.1016/j.hjc.2017.08.008

Cited by 30 publications

(39 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7 In the cases of uncorrected septal defects, especially right-to-left shunt or bidirectional shunt, PH is a threatening condition that increases maternal mortality. [2][3][4]7 Due to improvement in peripartum management involving multidisciplinary teams and availability of PH-specific medication, the maternal mortality in pregnant women with CHD-PH is reduced as low as 3.8%. 2 However, in our hospital registry, the maternal mortality rate among pregnant patients with CHD-PH was still high.…”

Section: Discussionmentioning

confidence: 99%

Severe pulmonary hypertension and reduced right ventricle systolic function associated with maternal mortality in pregnant uncorrected congenital heart diseases

et al. 2019

View full text Add to dashboard Cite

Background: Pregnant uncorrected congenital heart disease patients, especially those who already developed pulmonary hypertension, have increased risk for maternal mortality. The pulmonary hypertension severity and right ventricle function may be associated with higher maternal mortality. The study aimed to investigate the mortality rate of pregnant uncorrected congenital heart disease and the impact of pulmonary hypertension severity on mortality. Methods: This is the sub study of COngenital HeARt Disease in adult and Pulmonary Hypertension Registry. The data of pregnant uncorrected congenital heart disease patients were analyzed from registry database. The maternal mortality was recorded. The data of demography, clinics, obstetrics, and transthoracic echocardiography were collected. The factors that influenced maternal mortality were analyzed. A statistical significance was determined when p value < 0.05. Results: From 2012 until 2017, there were 78 pregnant congenital heart disease patients. Of them, 56 patients were eligible for analyses. The majority of congenital heart disease was atrial septal defect (91.1%). The maternal mortality rate was 10.7% (6 of 56). Pulmonary hypertension occurred in 48 patients, therefore the maternal mortality rate among congenital heart diseasepulmonary hypertension with majority of atrial septal defect was 12.5% (6 of 48). Among nonsurvivors, 100% suffered from severe pulmonary hypertension as compared to survivors (56.0%), p ¼ 0.041. Most nonsurvivors were Eisenmenger syndrome (83.3%), significantly higher compared to survivors (22.0%), p ¼ 0.006. Nonsurvivors had significantly worsened WHO functional class, reduced right ventricle systolic function, and right heart failure. The modes of maternal death were severe oxygen desaturation (66.7%) and respiratory failure and sepsis (33.3%). Most of the maternal deaths occurred within 24 h postpartum period. Conclusion: Maternal mortality rate among pregnant uncorrected congenital heart disease with majority of atrial septal defect was 10.7% and among congenital heart disease-pulmonary hypertension with majority of atrial septal defect was 12.5%. Factors related with maternal mortality were severe pulmonary hypertension, Eisenmenger syndrome, and reduced right ventricle systolic function.

show abstract

Section: Discussionmentioning

confidence: 99%

Severe pulmonary hypertension and reduced right ventricle systolic function associated with maternal mortality in pregnant uncorrected congenital heart diseases

et al. 2019

View full text Add to dashboard Cite

show abstract

“…6 Although pregnancy is often tolerated and well managed in women with ACHD, 7 a systematic review involving 2491 pregnancies in women with ACHD 8 found that adverse maternal, obstetric, and neonatal events occur at a higher rate than in the general obstetric population. 9,10…”

Section: Introductionmentioning

confidence: 99%

“…Although previous studies have demonstrated increased obstetric and neonatal risks for women with ACHD, most only included patients seen in tertiary care centers, 7,9,10,11,13,16,17 combined women with structural and acquired heart disease, 11,13,14,15 or lacked a control group. 7,9,10,11,14,16,17 In Canada, only 23% of patients with ACHD are regularly followed up by physicians at a specialized ACHD clinic; therefore, previous studies may not be generalizable to current practice. 18 In addition, previous studies have lacked the power to examine outcomes by ACHD subtype to determine whether all patients are uniformly at increased risk of adverse obstetric or neonatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

View full text Add to dashboard Cite

Key Points Question Do pregnancy, maternal, and neonatal outcomes differ in women with different types of adult congenital heart disease? Findings In this large cross-sectional study of 2114 women with adult congenital heart disease in Canada, maternal and neonatal outcomes varied by subtype of maternal heart condition. Adult congenital heart disease was associated with increased odds of adverse maternal, neonatal, and pregnancy outcomes during labor and delivery hospitalization. Meaning These findings may help to highlight the importance of understanding and considering subtypes of adult congenital heart disease in clinical management of these high-risk pregnancies.

show abstract

“…9 Interestingly, in more than a third of the cohort the establishment of PAH-CHD diagnosis occurred during pregnancy, which was also a finding in previous studies. 10,11 Notably, some of the patients were referred late in their pregnancies as emergencies in the tertiary centre. 8 In total, 6.4% of pregnant women died, 35.1% developed heart failure and 10.6% experienced a pulmonary hypertension crisis.…”

Section: Despoina Ntiloudi and George Giannakoulasmentioning

confidence: 99%

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

Ntiloudi

Giannakoulas

2019

Eur J Prev Cardiolog

Self Cite

View full text Add to dashboard Cite

Pregnancy outcome in women with congenital heart disease: A single-center experience

Abstract: Pregnancies in ACHD patients are at high risk for complications. Advanced modified WHO class, prior medication use, and high BMI were related to adverse cardiac events.

Cited by 30 publications

References 21 publications

Severe pulmonary hypertension and reduced right ventricle systolic function associated with maternal mortality in pregnant uncorrected congenital heart diseases

Severe pulmonary hypertension and reduced right ventricle systolic function associated with maternal mortality in pregnant uncorrected congenital heart diseases

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

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

Contact Info

Product

Resources

About