medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2024, Number 11

<< Back Next >>

Ginecol Obstet Mex 2024; 92 (11)

Maternal heart disease and pregnancy. Three years’ experience in a referral hospital

de Castro ML, Rodríguez MF, Martín BME, Ruíz CJ, Fernández MMC, Bartha RJL

Language: Spanish
References: 15
Page: 441-449
PDF size: 211.55 Kb.


ABSTRACT

Objectives: To describe the main characteristics of pregnant patients with heart disease, to describe the follow-up and evolution of their pregnancies, delivery conditions and perinatal outcomes.
Materials and Methods: Observational, descriptive and retrospective study carried out in pregnant patients with cardiac disease attended between March 2021 and September 2023 at the Hospital Universitario La Paz, Madrid, Spain. Study parameters: maternal characteristics, prenatal care, obstetric and fetal complications, information on type of abortion and perinatal outcomes.
Results: Thirty-nine patients were studied, 34 of whom had maternal congenital heart disease with NYHA functional class I-IV. Cesarean section was indicated in nine patients. There was one case of fetal heart disease, two cases of intrauterine growth restriction, one case of nonviable premature rupture of membranes, one antepartum puntafetal death, and four preterm deliveries. Maternal complications were less severe in patients with NYHA functional class 1.
Conclusions: Although the total number of cases in each functional class was small, the trend toward complications described in the literature like increased risk of preterm delivery, neonatal disease recurrence, fetal growth restriction, and increased maternal morbidity were found. It is clear that preconception counseling and adequate multidisciplinary follow-up are essential to achieve good perinatal outcomes.


REFERENCES

  1. Múnera-Echeverri AG. Enfermedad cardiaca y embarazo.Rev Colomb Cardiol 2018; 25: 49-58. https://doi.org/10.1016/j.rccar.2017.11.028

  2. Elkayam U, Goland S, Pieper PG, Silversides CK. High-riskcardiac disease in pregnancy. J Am Coll Cardiol 2016; 68(4): 396-410. https://doi.org/10.1016/j.jacc.2016.05.048

  3. Pijuan Domènech A et al. Embarazo y cardiopatía. RevEsp Cardiol 2006 ;59 (9): 971-84. https://ais.paho.org/classifications/chapters/pdf/volume1.pdf

  4. Hospital Clinic. Cardiopatía materna y gestación. Protocologuía clínica. Centro de Medicina Fetal y Neonatal deBarcelona. https://ais.paho.org/classifications/chapters/pdf/volume1.pdf

  5. Panamericana, Oficina Sanitaria. Organización Mundialde la Salud Clasificación estadística internacional de enfermedadesy problemas relacionados con la salud. 10rev. Publicación científica, vol. 554. https://ais.paho.org/classifications/chapters/pdf/volume1.pdf

  6. Thorne S, MacGregor A, Nelson-Piercy C. Risk of contraceptionand pregnancy in heart disease. Heart 2006; 92:1520-5. https://doi.org/10.1136/hrt.2006.095240

  7. Silversides CK, Grewal J, Mason J, Sermer M, et al. Pregnancyoutcomes in women with heart disease: The CARPREGII Study. J Am Coll Cardiol 2018; 71 (21): 2419-30. https://doi.org/10.1016/j.jacc.2018.02.076

  8. Hardee I, Wright L, McCracken C, Lawson E, et al. Maternal andneonatal outcomes of pregnancies in women with congenitalheart disease: A meta-analysis. J Am Heart Assoc 2021; 10 (8):e017834. https://doi.org/10.1161/JAHA.120.017834

  9. Panebianco M, Perrone MA, Gagliardi MG, Galletti L, et al.Pregnancy in Patients with Moderate and Highly ComplexCongenital Heart Disease. Healthcare (Basel) 2023; 11(11): 1592. https://doi.org/10.3390/healthcare11111592

  10. Roos-Hesselink J, Baris L, Johnson M, De Backer J, et al.Pregnancy outcomes in women with cardiovascular disease:Evolving trends over 10 years in the ESC Registry ofPregnancy and Cardiac disease (ROPAC). Eur Heart J 2019;40: 3848-55. https://doi.org/10.1093/eurheartj/ehz136

  11. Greutmann M, Pieper PG. Pregnancy in women with congenitalheart disease. Eur Heart J 2015; 36 (37): 2491-9.https://doi.org/10.1093/eurheartj/ehv288

  12. Drenthen W, Boersma E, Balci A, Moons P, et al. Predictorsof pregnancy complications in women with congenitalheart disease. Eur Heart J 2010; 31: 2124-132. https://doi.org/10.1093/eurheartj/ehq200

  13. Drenthen W, Pieper PG, Roos-Hesselink JW, van LottumWA, et al. Outcome of pregnancy in women withcongenital heart disease: a literature review. J Am CollCardiol 2007; 49: 2303-311. https://doi.org/10.1016/j.jacc.2007.03.027

  14. Burn J, Brennan P, Little J, Holloway S, et al. Recurrencerisks in offspring of adults with major heart defects: resultsfrom first cohort of British collaborative study. Lancet1998; 351: 311-16.

  15. Kirby A, Curtis E, Hlohovsky S, Brown A, et al. Pregnancyoutcomes and risk evaluation in a contemporaryadult congenital heart disease cohort. Heart LungCirc 2021; 30 (9): 1364-72. https://doi.org/10.1016/j.hlc.2021.03.005




2020     |     www.medigraphic.com