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

Z Kardiol. 2003 Jan;92(1):16-23. doi: 10.1007/s00392-003-0880-0.

Abstract

Objectives: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Cause of Death
  • Cesarean Section
  • Combined Modality Therapy
  • Extraction, Obstetrical
  • Female
  • Fetal Death / epidemiology
  • Germany
  • Heart Defects, Congenital / mortality
  • Heart Defects, Congenital / therapy*
  • Humans
  • Infant, Newborn
  • Neonatal Screening
  • Obstetric Labor Complications / mortality
  • Obstetric Labor Complications / therapy*
  • Patient Care Team*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / mortality
  • Pregnancy Complications, Cardiovascular / therapy*
  • Pregnancy Outcome
  • Prospective Studies
  • Puerperal Disorders / mortality
  • Puerperal Disorders / therapy*
  • Survival Analysis