Cardiology 2013. Part II.

 

 

Reference Type:  Journal Article

Record Number: 1069Author: Roos-Hesselink, J. W., Ruys, T. P., Stein, J. I., Thilen, U., Webb, G. D., Niwa, K., Kaemmerer, H., Baumgartner, H., Budts, W., Maggioni, A. P., Tavazzi, L., Taha, N., Johnson, M. R., Hall, R. and Investigators, Ropac

Year: 2013

Title: Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology

Journal: Eur Heart J

Volume: 34

Issue: 9

Pages: 657-65

Date: Mar

Short Title: Outcome of pregnancy in patients with structural or ischaemic heart disease: results of a registry of the European Society of Cardiology

Alternate Journal: European heart journal

ISSN: 1522-9645 (Electronic)

0195-668X (Linking)

DOI: 10.1093/eurheartj/ehs270

Accession Number: 22968232

Keywords: Adolescent

Adult

Cardiomyopathies/*epidemiology/mortality

Cesarean Section/statistics & numerical data

Developed Countries/statistics & numerical data

Developing Countries/statistics & numerical data

Europe/epidemiology

Female

Fetal Death/epidemiology

Heart Defects, Congenital/*epidemiology/mortality

Heart Valve Diseases/*epidemiology/mortality

Hospitalization/statistics & numerical data

Humans

Maternal Age

Maternal Mortality

Middle Aged

Myocardial Ischemia/*epidemiology/mortality

Pregnancy

Pregnancy Complications, Cardiovascular/*epidemiology/mortality

Pregnancy Outcome/epidemiology

Registries

Retrospective Studies

Young Adult

Abstract: AIMS: To describe the outcome of pregnancy in patients with structural or ischaemic heart disease. METHODS AND RESULTS: In 2007, the European Registry on Pregnancy and Heart disease was initiated by the European Society of Cardiology. Consecutive patients with valvular heart disease, congenital heart disease, ischaemic heart disease (IHD), or cardiomyopathy (CMP) presenting with pregnancy were enrolled. Data for the normal population were derived from the literature. Sixty hospitals in 28 countries enrolled 1321 pregnant women between 2007 and 2011. Median maternal age was 30 years (range 16-53). Most patients were in NYHA class I (72%). Congenital heart disease (66%) was most prevalent, followed by valvular heart disease 25%, CMP 7%, and IHD in 2%. Maternal death occurred in 1%, compared with 0.007% in the normal population. Highest maternal mortality was found in patients with CMP. During pregnancy, 338 patients (26%) were hospitalized, 133 for heart failure. Caesarean section was performed in 41%. Foetal mortality occurred in 1.7% and neonatal mortality in 0.6%, both higher than in the normal population. Median duration of pregnancy was 38 weeks (range 24-42) and median birth weight 3010 g (range 300-4850). In centres of developing countries, maternal and foetal mortality was higher than in centres of developed countries (3.9 vs. 0.6%, P < 0.001 and 6.5 vs. 0.9% P < 0.001) CONCLUSION: The vast majority of patients can go safely through pregnancy and delivery as long as adequate pre-pregnancy evaluation and specialized high-quality care during pregnancy and delivery are available. Pregnancy outcomes were markedly worse in patients with CMP and in developing countries.

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