心血管疾患と診断

Pregnancy in Adult Congenital Heart Disease Maternal and Fetal Outcome, a Single Centre Study in a Developing Country

Abstract

Dina Adel Ezzeldin, Alaa Roshdy, Hebatalla Attia, Azza Elfiky and Amira Nour

Background: Women with congenital heart disease represent the largest group of women with cardiac disease in the child bearing period. This poses additional burden on the medical system as theses mothers and their infants require special care.
Methods: This was a cross sectional observational study involving 90 female patients in the child bearing period who came for regular follow up visit in the adult congenital heart disease clinic in our hospital over a period of 12 months. A custom-made sheet was done including maternal diagnoses, age of the patient, age during the first pregnancy, and maternal morbidity during pregnancy and fetal outcome.
Results: The mean age of the patients was 35.4 ± 12.2 years. 97.7% of these patients report at least one successful pregnancy; the mean age at time of first pregnancy was 22.77 ± 2.97 years. The average number of offsprings was 1.6. Forty-one (41) of our patients saught medical advice because of being pregnant, 24 of which were pregnant for the first time. The patients most common underlying heart disease was ASD (n=39), VSD (n=11) and AVCD (n=10) but still more complex diagnosis was present; TOF (n=4) L-TGA (n=3), Truncus (n=1) Ebstein anomaly (n=2). 62.2% of the patients did not report any maternal morbidity during pregnancy. The most common morbidities were complete heart block (n=5), abortion (n=5), progressive heart failure (n=3), stroke (n=3), progressive pulmonary hypertension (n=4). Among the 143 offsprings delivered only 12 were abnormal, 8 of which had ASD and none of them had complex CHD.
Conclusion: Although pregnancy in adult patients with congenital heart disease is feasible especially in patients with simple lesions, special attention is needed to guard against maternal morbidity.