Open AccessMaternal Heart Disease
Author(s) -
Bitsch Mikael,
Johansen Christoffer,
Wennevold Alf,
Osler Mogens
Publication year - 1989
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016348909009898
Subject(s) - medicine , heart disease , pregnancy , incidence (geometry) , population , coarctation of the aorta , gestational age , cardiology , great arteries , tetralogy of fallot , pediatrics , obstetrics , aorta , genetics , physics , environmental health , optics , biology
Among 87 pregnancies complicated by heart disease, delivered during the decade 1977–86, 70 (81%) had a congenital heart malformation. 7 (8%) an acquired heart disease and 10 (11%) arrhythmias or conduction disturbances. The incidence was 0.3 %. The corresponding data from a report from Rigshospitalet during the 1950s were: 42%. 49%, and 9%, respectively, and an incidence of 0.9%. Ventricular septal defect (VSD) and atrial septal defect (ASD) were the most frequent malformations. The women were classified according to the NYHA before, during and after the pregnancy. All women except 4 re‐entered their original functional class. In 51 cases, ECG showed completely normal sinus rhythm, while in 36, various degrees of arrhythmia or conduction disturbance were found as well as left or right ventricular hypertrophy and/or strains. Nine infants had congenital defects, 4 of which were a heart malformation (4.6%). One infant died. Gestational duration, weight and perinatal mortality did not differ significantly from that of the general population. Two women died, one of primary pulmonary hypertension and one with a rupture of the thoracic aorta. Rheumatic heart disease is no longer a significant factor in relation to pregnancy in Denmark, but congenital heart disease is still of great importance, because more survive and reach the age of fertility. Today most women can be brought safely through pregnancy, but obstetric, cardiologic and anesthesiologic expertise is still mandatory for a successful course and outcome of pregnancies complicated by heart disease.