Pregnancy in women with congenital heart disease

  • Dr Julia Zareba-Szczudlik, 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
  • Dr Hanna Siudalska, Istitute of Cardiology, Warsaw, Poland
  • Prof Krzysztof Czajkowski, 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
  • Dr Joanna Dangel, Perinatal Cardiology Department, 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland

    • The aim of the study was to assess the perinatal outcome of women with congenital heart disease (CHD).
    We evaluated 38 pregnant women with CHD: 16 with low maternal mortality risk (LMMR) and 22 with middle maternal mortality risk (MMMR), from whom the most complicated were: 2-Fontan, 1-severeAS, 2-Ebstein, 2-Marfan.
    Results: There was one spontaneous abortion in each groups. The most frequent complications was hypertension in MMMR-group and gestational diabetes and arrhythmia in each groups. One from LMMR and 8 from MMMR were given 24mg of Betamethasone at 28-th week because of risk of premature delivery. 10 women were treated with beta-blockers and 4 with methyldopa. Two patients were given low molecular weight heparin and one - acenocumarol. Only 2 patients of MMMR delivered prematurely. Caesarean section was performed in 16 of MMMR-patients (10-cardiological indications, 4-fetal asphyxia) and in 5 of LMMR-patients (1-cardiological indication, 4-fetal asphyxia, 1-prolonged labour). The mean birth weight was 3220+439 grams in LMMR-group and 2863+483 grams in MMMR-group. There were 4 cases of IUGR in MMMR-group. 21 neonates of MMMR were delivered in good condition according to Apgar score and 1 in poor condition. 13 neonates of LMMR were delivered in good condition. CHD in fetuses were in 2pts with AS and ASDII.
    One patient with Marfan syndrome died due to thrombosis of mechanical aortic valve. Otherwise no serious complications during labour and after delivery were observed.
    Conclusions: Pregnant women with congenital heart disease are at higher risk for cardiovascular and neonatal complications.