Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
Hellenic J Cardiol. 2018 May-Jun;59(3):155-159. doi: 10.1016/j.hjc.2017.08.008. Epub 2017 Sep 2.
Pregnancies in patients with adult congenital heart disease (ACHD) are often complicated. We aimed to highlight the nature and the rate of these complications in a single-center patient population.
We retrospectively studied all the pregnancies of women who presented on an outpatient basis, and all pregnancies were reviewed for maternal and fetal outcomes.
Of 117 pregnancies from 52 ACHD patients (age at pregnancy 28.3 ± 6.6 years), 10 were therapeutically aborted. A proportion of 41.1% of the remaining 107 pregnancies were complicated either with cardiac (3.7%), obstetric (15.0%), or fetal/neonatal (11.2%) adverse events or with spontaneous abortion (17.8%). Hospitalization during pregnancy was required in 10 patients. Elective cesarean sections were initially planned for 31% of the 87 pregnancies, which were finally completed, while 8% required an emergency cesarean section, mostly for obstetric reasons. NYHA class deterioration after pregnancy was detected in 9.3% of our cohort. Modified WHO class III/IV, prior medication use, and higher body mass index (BMI) were related to cardiac complications during pregnancy or NYHA deterioration.
Pregnancies in ACHD patients are at high risk for complications. Advanced modified WHO class, prior medication use, and high BMI were related to adverse cardiac events.
患有成人先天性心脏病（ACHD）的女性妊娠通常较为复杂。我们旨在强调单中心患者人群中这些并发症的性质和发生率。
我们回顾性研究了所有在门诊就诊的女性的妊娠情况，并对所有妊娠的母婴结局进行了评估。
在 52 名 ACHD 患者的 117 例妊娠中（妊娠时年龄 28.3±6.6 岁），有 10 例经治疗性流产。其余 107 例妊娠中，有 41.1%出现了心脏（3.7%）、产科（15.0%）或胎儿/新生儿（11.2%）不良事件或自然流产（17.8%）。有 10 名患者在妊娠期间需要住院治疗。最初计划对 87 例妊娠中的 31%进行选择性剖宫产，最终完成了这些手术，而 8%需要紧急剖宫产，主要是因为产科原因。我们的队列中有 9.3%的患者在妊娠后出现纽约心脏协会（NYHA）心功能分级恶化。改良的世界卫生组织（WHO）心功能分级 III/IV 级、既往用药和较高的体重指数（BMI）与妊娠期间的心脏并发症或 NYHA 恶化有关。
ACHD 患者的妊娠存在较高的并发症风险。改良的 WHO 心功能分级较高、既往用药和较高的 BMI 与不良心脏事件相关。
