The Evaluation of the Pregnants with Cardiac Disorders: Three-Year Experience of an University Hospital
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Research Article
P: 194-199
December 2018

The Evaluation of the Pregnants with Cardiac Disorders: Three-Year Experience of an University Hospital

J Ankara Univ Fac Med 2018;71(3):194-199
1. Dicle Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Diyarbakır, Türkiye
2. Diyarbakır Eğitim ve Araştırma Hastanesi, Kardiyoloji Kliniği, Diyarbakır, Türkiye
3. Yozgat Bozok Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Yozgat, Türkiye
No information available.
No information available
Received Date: 15.10.2018
Accepted Date: 18.12.2018
Publish Date: 26.03.2019
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ABSTRACT

Objectives:

The main purpose of our study is to examine cases of pregnant patients with heart diseases in our tertiary referral hospital and to evaluate fetal and maternal outcomes.

Materials and Methods:

Pregnants with gestational age of 20 weeks or more and with any previous cardiac diseases were examined between 2013 and 2015 retrospectively. Fetal and maternal clinical data were collected accordingly.

Results:

In total, 6599 live births were carried out in our hospital. Of them, there were 120 pregnants with cardiac disease. Rheumatic valvular heart disease was the most common (n=66, 55%) disorder among the pregnants, followed by the heart rhythm disorders respectively (n=15; 12.5%). Twelve patients had congestive heart failure; twelve patients with congenital heart disease, eight patients with aort valve or aorta pathology; four with pulmonary hypertension, two with coronary artery disease and one with pericardial effusion. Three pregnants had left ventricular ejection fraction (LVEF) of less than 35%, six pregnants had LVEF between 35 to 50% and the rest of the pregnants had LVEF of >50%. Maternal death was not encountered, 22 patients (18.3%) were followed in cardiology intensive care unit postoperatively. Neonatal mortality was developed in 2 cases (1.66%) and the neonatal morbidity was developed in 6 cases (5%). The most common form of delivery was caesarean section (n=97, 81%). Premature birth ratio was 37.5% (n=45).

Conclusion:

Pregnants with heart disease have chance to give healthy births with low risk for maternal or neonatal complications provided close follow-up by a team of cardiologist, anesthetist, and obstetrician experienced in this field.

Keywords: Heart Disease, Pregnancy, Maternal Morbidity

References

1
Weiss BM, von Segesser LK, Alon E, et al. Outcome of cardiovasculer surgery and pregnancy; a systematic review of the period 1984-1996. Am J Obstet Gynecol. 1998;179:1643-1653.
2
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al; ESC Scientific Document Group. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39:3165-3241.
3
Cheitlin MD. Cardiac problems in pregnancy. Maternal aspects to the pregnant patient with heart disease. JAMA. 1984;251:2838-2839.
4
Phillips S, Pirics M. Congenital Heart Disease and Reproductive Risk: An Overview for Obstetricians, Cardiologists, and Primary Care Providers. Methodist Debakey Cardiovasc J. 2017;13:238-242.
5
Mc Faul PB, Dorman JC, Lamki H. Pregnancy complicated by maternal heart disease. A review of 519 women. Br J Obstet Gynecol. 1988;95:861-868.
6
Aydin E, Ozyuncu O, Kasapoglu D, et al. Clinical analyses of 383 cases with maternal cardiac diseases. J Perinat Med. 2018;46:293-298.
7
Xu L, Liu X, Wu S, et al. The clinical application value of the plasma copeptin level in the assessment of heart failure with reduced left ventricular ejection fraction: A cross-sectional study. Medicine (Baltimore). 2018;97:e12610.
8
Simpson LL. Maternal cardiac disease: update for the clinician. Obstet Gynecol. 2012;119:345-359.
9
Berg CJ, Callaghan WM, Syverson C, et al. Pregnancy-related mortality in the US, 1998 to 2005. Obstet Gynecol. 2010;116:1302-1309.
10
Small MJ, James AH, Kershaw T, et al. Near-miss maternal mortality: cardiac dysfunction as the principal cause of obstetric intensive care unit admissions. Obstet Gynecol. 2012;119:250-255.
11
Fryar CD, Chen T, Li X. Prevalance of uncontrolled risk factors for cardiovascular disease: US, 1999-2010. NCHS Data Brief. 2012;103:1-8.
12
Seshadri S, Oakeshott P, Nelson- Piercy C, et al. Pregnancy care. BMJ 2012;344:e3467.
13
Siu SC, Sermer M, Colman JM, et al. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation. 2001;104:515-521.
14
Mc Faul PB, Dornan JC, Lamki H, et al. Pregnancy complicated by maternal heart disease: a review of 519 woman. Br J Obstet Gynaecol. 1988;95:861-867.
15
Madazli R, Şal V, Çift T, et al. Pregnancy outcomes in women with heart disease. Arch Gynecol Obstet. 2010;281:29-34.
16
Oron G, Hirsch R, Ben-Haroush A, et al. Pregnancy outcome in women with heart disease undergoing induction of labour. BJOG. 2004;111:669-675.
17
Nassar AH, Hobeika EM, Abd Essamed HM, et al. Pregnancy outcome in women with prosthetic heart valves. Am J Obstet Gynecol. 2004;191:1009-1013.
18
McLintock C. Anticoagulant therapy in pregnant women with mechanical prosthetic heart valves: no easy option. Thromb Res. 2011;127:S56-60.
19
Cotrufo M, De Feo M, De Santo LS, et al. Risk of warfarin during pregnancy with mechanical valve prostheses. Obstet Gynecol. 2002;99:35-40.
20
Al-Talib TK, Liu SS, Srivastava M. Cardiovascular Emergencies in Pregnancy. Cardiol Clin. 2018;36:171-181.
21
Freidman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. 2008;6:235-248.
22
Datt V, Tempe DK, Virmani S, et al. Anesthetic management for emergency cesarean section and aortic valve replacement in a parturient with severe bicuspid aortic valve stenosis and congestive heart failure. Ann Card Anaesth. 2010;13:64-68.
23
Hameed A, Karaalp IS, Tummala PP, et al. The effect of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol. 2001;37:893-899.
24
Kizer JR, Devereux RB, Patent foramen ovale in young adults with unexplained stroke. N Engl J Med. 2005;353:2361-2372.
25
Curry RA, Fletcher C, Gelson E, et al. Pulmonary hypertension and pregnancy- a review of 12 pregnancies in nine women. BJOG. 2012;119:752-761.
26
Weiss BM, Zemp L, Seifert B, et al. Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am Coll Cardiol. 1998;31:1650-1657.
27
Patten IS, Rana S, Shahul S, et al. Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. Nature 2012;485:333-338.
28
Cunningham FG. Peripartum cardiomyopathy: we’ve come a long way, but… Obstet Gynecol 2012;120:992-994.
29
Gunderson EP, Croen LA, Chiang V, et al. Epidemiology of peripartum cardiomyopathy: incidence, predictors, and outcomes. Obstet and Gynecol. 2011;118:583-591.
30
Mielniczuk LM, Williams K, Davis DR, et al. Peripartum cardiomyopathy: frequency of peripartum cardiomyopathy. Am J Cardiol. 2006;97:1765-1768.
31
Gowda RM, Khan IA, Mehta NJ, et al. Cardiac arrhythmias in pregnancy: clinical and therapeutic considerations. Int J Cardiol. 2003;88:129-133.
32
Robins K, Lyons G. Supraventricular tachycardia in pregnancy. Br J Anaesth 2004;92:140-143.
33
Maxwell C, Poppas A, Sermer M. Heart disease in pregnancy. In Powrie R, Greene MF, Camann W (eds): de Swiet’s Medical Disorders, 5th ed. Wiley-Blackwell, Oxford, 2010, p 118.
34
Ladner HE, Danielser B, Gilbert WM. Acute myocardial infarction in pregnancy and the puerperium: a population-based study. Obstet Gynecol. 2005;105:480-484.
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