Pregnant Women With Uncorrected Congenital Heart Disease

Sliwa, Karen; Baris, Lucia; Sinning, Christoph; Zengin-Sahm, Elvin; Gumbienė, Lina; Yaseen, Israa Fadhil; Youssef, Ghada; Johnson, Mark R.; Farhan, Hasan Ali; Lelonek, Małgorzata; Hall, Roger; Roos‐Hesselink, Jolien W.

doi:10.1016/j.jchf.2019.09.001

Cited by 38 publications

(29 citation statements)

References 28 publications

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“…A relatively low maternal mortality rate of 4.8% was also reported in uncorrected CHD with PH in another ROPAC analysis [5]. Nevertheless, this rate was markedly higher than the 0.2% mortality observed among uncorrected CHD without PH.…”

Section: Discussionmentioning

confidence: 69%

“…Other etiologies of pre-capillary PH such as chronic thromboembolic, chronic lung, and sickle cell disease are less common during pregnancy. Within group 1 PH, idiopathic PAH (IPAH) predominates in developed countries [3•, 4], whereas PAH associated with congenital systemic to pulmonary shunts (PAH-CHD) is more prevalent in resource-limited nations [5]. PAH associated with connective tissue disorders and other conditions may also be encountered in pregnancy [6,7].…”

Section: Overview Of Ph During Pregnancymentioning

confidence: 99%

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Pulmonary Hypertension Complicating Pregnancy

et al. 2021

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Purpose of review This study aims to describe the pathophysiology of pregnancy in pulmonary hypertension (PH) and review recent literature on maternal and fetal outcomes. Recent findings There is an increasing number of pregnant women with PH. Maternal mortality in pulmonary arterial hypertension (PAH) ranges from 9 to 25%, most commonly from heart failure and arrythmias. The highest risk of death is peri-partum and post-partum. Fetal/neonatal morbidity and mortality are also substantial. There are high rates of prematurity, intrauterine growth retardation, and preeclampsia. Women should be referred to expert centers for management. Combination PAH therapy with parenteral prostacyclin and a phosphodiesterase type V inhibitor is recommended. Induced vaginal delivery is preferred, except in cases of severe heart failure or obstetric indications for cesarean section. Summary Despite advances in management, pregnancy in PAH remains a high-risk condition and should be prevented.

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Section: Discussionmentioning

confidence: 69%

Section: Overview Of Ph During Pregnancymentioning

confidence: 99%

Pulmonary Hypertension Complicating Pregnancy

et al. 2021

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“…This study also showed that maternal death recorded were higher in the CHD group, although statistically insignificant. Undiagnosed heart disease, delay in management, and unrepaired congenital heart disease could lead to complications and worsen maternal outcomes 32 . Thus, early diagnosis of the newborn's asymptomatic congenital heart disease will significantly benefit this condition.…”

Section: Discussionmentioning

confidence: 99%

Characteristics Shifting of Heart Disease in Pregnancy: A Report from Low Middle-Income Country

Pitaloka

Secka

Ernawati

et al. 2021

Journal of Public Health Research

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Background: Heart disease in pregnancy is one of the leading causes of maternal mortality and morbidity in developing countries. However, the characteristics of the disease vary between countries and regions. This study aimed to present the characteristics of pregnant women with heart disease in an economically advantageous region of a developing country.Design and methods: A cross-sectional study was conducted using data from the Weekly Report of Obstetrics and Gynaecology Department to assess pregnant women with heart disease characteristics and pregnancy outcomes. A total sample of 69 pregnant women with heart disease regarding their gestational age was included in the study. Variables observed were maternal characteristics, heart disease's clinical parameters, and maternal and neonatal outcomes. Chi-square test was used to examine the different characteristics of congenital and acquired heart disease groups.Results: The prevalence of cardiac disease in pregnancy was 5.19%. Fifty-three point six percent of pregnant women with heart disease were suffered from congenital heart disease (CHD), while 46.4% were acquired heart disease (AHD). Most labor methods were Cesarean delivery, and 69.6% of women experienced cardiac complications. Maternal death was reported in 8.69% of cases. Four cases were CHD complicated by pulmonary hypertension, which leads to Eisenmenger syndrome. Two other cases were AHD complicated by Peripartum Cardiomyopathies. Although statistically insignificant, complications are more common in the AHD group than CHD.Conclusion: Cardiac disease prevalence in pregnancy is considered high, with CHD as the most common case, which significantly differs from other developing countries.

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“… 6 , 8 , 32 Though mothers with ACHD saw the best outcomes of those with known heart disease, findings were worse for those whose lesions remained uncorrected or who had shunt lesions present. 33 …”

Section: Cause and Timing Of Heart Failurementioning

confidence: 99%

Maternal Heart Failure

Bright

Lima

Avila

et al. 2021

JAHA

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Heart failure (HF) remains the most common major cardiovascular complication arising in pregnancy and the postpartum period. Mothers who develop HF have been shown to experience an increased risk of death as well as a variety of adverse cardiac and obstetric outcomes. Recent studies have demonstrated that the risk to neonates is significant, with increased risks in perinatal morbidity and mortality, low Apgar scores, and prolonged neonatal intensive care unit stays. Information on the causal factors of HF can be used to predict risk and understand timing of onset, mortality, and morbidity. A variety of modifiable, nonmodifiable, and obstetric risk factors as well as comorbidities are known to increase a patient's likelihood of developing HF, and there are additional elements that are known to portend a poorer prognosis beyond the HF diagnosis. Multidisciplinary cardio‐obstetric teams are becoming more prominent, and their existence will both benefit patients through direct care and increased awareness and educate clinicians and trainees on this patient population. Detection, access to care, insurance barriers to extended postpartum follow‐up, and timely patient counseling are all areas where care for these women can be improved. Further data on maternal and fetal outcomes are necessary, with the formation of State Maternal Perinatal Quality Collaboratives paving the way for such advances.

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Pregnant Women With Uncorrected Congenital Heart Disease

Cited by 38 publications

References 28 publications

Pulmonary Hypertension Complicating Pregnancy

Pulmonary Hypertension Complicating Pregnancy

Characteristics Shifting of Heart Disease in Pregnancy: A Report from Low Middle-Income Country

Maternal Heart Failure

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