Pregnancy in congenital cardiac disease: an increasing challenge for cardiologists and obstetricians: a prospective multicenter study

Aim of this study was to assess the occurrence of pregnancy-related complications of mother and child during pregnancy, delivery and puerperium in women with CCD prospectively. STUDY DESIGN, POPULATION: This prospective multicenter study included 122 pregnancies in 106 women with CCD (72 with, 34 wi...

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Bibliographic Details
Published in:Clinical research in cardiology 2003, Vol.92 (1), p.16-23
Main Authors: KAEMMERER, H, BAUER, U, LANGE, P. E, BEITZKE, A, SCHNEIDER, K. T. M, HESS, J, STEIN, J.-I, LEMP, S, BARTMUS, D, HOFFMANN, A, NIESERT, S, OSMERS, R, FRATZ, S, ROSSA, S
Format: Article
Language:English
Subjects:
Abortion
Adolescent
Adult
Biological and medical sciences
Bleeding
Cause of Death
Cesarean Section
Combined Modality Therapy
Complications
Coronary artery disease
Cyanosis
Diseases of mother, fetus and pregnancy
Endocarditis
Extraction, Obstetrical
Female
Fetal Death - epidemiology
Germany
Gynecology. Andrology. Obstetrics
Heart Defects, Congenital - mortality
Heart Defects, Congenital - therapy
Heart diseases
Heart surgery
Humans
Hypertension
Infant, Newborn
Medical sciences
Neonatal Screening
Obstetric Labor Complications - mortality
Obstetric Labor Complications - therapy
Patient Care Team
Physicians
Population studies
Pregnancy
Pregnancy complications
Pregnancy Complications, Cardiovascular - mortality
Pregnancy Complications, Cardiovascular - therapy
Pregnancy Outcome
Pregnancy. Fetus. Placenta
Premature birth
Prospective Studies
Puerperal Disorders - mortality
Puerperal Disorders - therapy
Puerperium
Survival Analysis
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Summary:Aim of this study was to assess the occurrence of pregnancy-related complications of mother and child during pregnancy, delivery and puerperium in women with CCD prospectively. STUDY DESIGN, POPULATION: This prospective multicenter study included 122 pregnancies in 106 women with CCD (72 with, 34 without previous cardiac surgery). Patient age was 17-44, median 26 years. Cardiac and non-cardiac complications, mode of delivery, abortion, and CCD of the newborn were assessed. Initially all women were in Functional Class I or II. Worsening during pregnancy occurred in 25.5% (n=27), mainly during the second and third trimester. Significant problems due to bleeding, hypertension, rhythm disturbances, endocarditis, liver congestion, increasing cyanosis or death, occurred in 11.3%. Twelve per cent of deliveries were premature. Five women had therapeutic abortion, nine spontaneous abortions, nine preterm births, and one intrauterine death. Seventy-nine per cent (n=85) delivered spontaneously; 21.3% (n=23) had caesarean section. Of the 111 live born children, 5.4% (n=6) had a CCD. Most women with CCD and a good functional class before pregnancy tolerate pregnancy without major problems. However, pregnancy may induce serious cardiac and obstetric complications. The specific risks require an individualized multidisciplinary patient-management by experienced physicians.
ISSN:0300-5860
1861-0684
1435-1285
1861-0692
DOI:10.1007/s00392-003-0880-0