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Maternal heart disease and pregnancy outcome: A single‐centre experience
Author(s) -
Stangl Verena,
Schad Johanna,
Gossing Gabriele,
Borges Adrian,
Baumann Gert,
Stangl Karl
Publication year - 2008
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2008.07.017
Subject(s) - medicine , pregnancy , heart disease , heart failure , ejection fraction , obstetrics , complication , cohort , abortion , cardiology , pediatrics , genetics , biology
Background: Maternal and neonatal complication rates are increased in pregnant women with heart disease. Cardiac risk assessment may be improved by defining low and high‐risk groups. Aims: To analyze pregnancy risks in low and high‐risk women with cardiovascular diseases. Methods and results: Pregnancy outcomes were analyzed in 93 consecutive women with heart disease, monitored in a single‐centre cohort between 1996 and 2006. Women were classified according to pre‐defined risk predictors as high‐risk (left ventricular [LV] ejection fraction <50%, NYHA class>II or cyanosis, peak LV outflow gradient >60 mmHg) or low‐risk (not meeting these criteria). Mean age was 28.1±5.7 years. 81.7% presented with congenital, 10.8% with acquired heart disease, and 7.5% with myocardial diseases. Severe maternal complications developed in 12.9% of all women: 6.5% heart failure, 3.2% arrhythmias, and 2.2% thrombotic complications. Maternal mortality was 1.1%. Women at high‐risk (24.7%) had a 6.1‐fold higher maternal complication rate and a 6.1 times higher foetal/neonatal event rate (abortion and stillbirth). 64.7% of the high‐risk women delivered prematurely, before the 37th week, compared to 16.4% in the low‐risk group. Conclusions: Despite pronounced clinical variability of congenital and acquired heart diseases, a small number of risk conditions can effectively characterize women in whom pregnancy is associated with appreciably increased maternal and foetal risk.