Congenital heart disease in pregnancy

Czech version

Authors: Žáková D.
Authors‘ workplace: Centrum kardiovaskulární a transplantační chirurgie Brno Centrum komplexní péče o vrozené srdeční vady v dospělosti Brno
Published in: Kardiol Rev Int Med 2018, 20(4): 273-278

Overview

Most women after surgery for congenital heart disease in childhood survive until an adult age. There has been an increasing number of women with congenital heart disease in the Czech Republic who want to become pregnant. The article presents and gives an overview of the issues associated with pregnant women with congenital heart defects and deals with the assessment of risk for the pregnant woman in relation to the basic diagnosis, the possibilities of preconception care and the most common complications in pregnancy and possible solutions.

Key words:

pregnancy – congenital heart disease – delivery – maternal mortality – risk stratification

Sources

1. Hoffman J, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2000; 39(12): 1890– 1900.

2. Warnes CA, Williams RG, Bashore TM et al. ACC/ AHA 2008 guidelines for the management of adults with congenital heart disease. J Am Coll Cardiol 2008; 52(23): e143– e263. doi: 10.1016/ j.jacc.2008.10.001.

3. Cantwell R, Clutton-Brock T, Cooper G. Saving mother’s lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The eight report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG 2011; 118 (Suppl 1): 1– 203. doi: 10.1111/ j.1471-0528.2010.02847.x.

4. Kuklina E, Callaghan W. Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995– 2006. BJOG 2011; 118(3): 345– 352. doi: 10.1111/ j.1471-0528.2010.02743.x.

5. CEMACH. CEMACH Saving Mothers’ Lives: Reviewing Maternal Deaths to Make Motherhood safer 2003– 2005: The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. London: Centre for Maternal and Child Enquiries 2008.

6. Burn J, Brennan P, Little J et al. Recurrence risks in offspring of adults with major heart defects: results from first cohort of British collaborative study. Lancet 1998; 351(9099): 311– 316.

7. Kapoor MC. Cardiopulmonary bypass in pregnancy. Ann Card Anaesth 2014; 17(1): 33– 39. doi: 10.4103/ 0971-9784.124133.

8. Ruys TP, Roos-Hesselink JW, Pijua-Domenech Aet al. Is a planned caesarean section in women with cardiac disease beneficial? Heart 2015: 101(7): 530– 536. doi: 10.1136/ heartjnl-2014-306497.

9. Royal College of Obstetricians and Gynaecologists. Antenatal corticosteroids to reduce nenatal morbidity and mortality. Royal College of Obstretricians and Gynaecologists Green-Top Guideline No. 7.London: Royal College of Obstetricians and Gynaecologists 2015.

10. Regitz-Zagrosek V, Roos-Hesselink JW, Baursachs Jet al. ESC Guidelines for the management of cardiovascular diseases during pregnancy of the European Society of Cardiology (ESC). Eur Heart J 2018; 39(34): 3165– 3241. doi: 10.1093/ eurheartj/ ehy340.

11. Krejčí J. Editorial. Proč bychom měli věnovat pozornost problematice kardiovaskulárních onemocnění v těhotenství? Kardiol Rev Int Med 2018; 20(4): 249– 250.

12. Greutmann M, Pieper PG. Pregnancy in women with congenital heart disease. Eur Heart J 2015; 36(37): 2491– 2499. doi: 10.1093/ eurheartj/ ehv288.

13. Roos-Hesselink JW, Budts W, Walker F. Organisation of care for pregnancy in patients with congenital heart disease. Heart 2017; 103(23): 1854– 1859. doi: 10.1136/ heartjnl-2017-311758.

14. Balci A, Drenthen W, Mulder BJ et al. Pregnancy in women with corrected tetralogy of Fallot: Occurrence and predictors of adverse events. Am Heart J 2011; 161(2): 307– 313. doi: 10.1016/ j.ahj.2010.10.027.

15. Kampman MA, Siegmund AS, Bilardo CM et al. Uteroplacental doppler flow and pregnancy outcome in women with tetralogy of Fallot. Ultrasound Obstet Gynecol 2017; 49(2): 231– 239. doi: 10.1002/ uog.15938.

16. Cataldo S, Doohan M, Rice K et al. Pregnancy following Mustard or Senning correction of transposition of the great arteries: a retrospective study. BJOG 2016; 123(5): 807– 813. doi: 10.1111/ 1471-0528.13508.

17. Stephen G, Vause S, Clarke B. Outcomes of pregnancy following maternal fontan repair. The 2nd international congress on cardiac problems in pregnancy 2012. Berlin. Abstract 123.

18. Cauldwell M, Von Klemperer K, Uebing A et al. Why is post-partum haemorrhage mor common in women with congenital heart disease ? Int J Cardiol 2016; 218: 285– 290. doi: 10.1016/ j.ijcard.2016.05.068.

19. Sliwa K, van Hagen IM Budts W et al. Pulmonary hypertension and pregnancy outcomes: Data from the Registry od Pregnancy and Cardiac Disease (ROPAC) of the European Society of Cardiolgy. Eur J Heart Fail 2016; 18(9): 1119– 1128. doi: 10.1002/ ejhf.594.

20. Duan R, Xu X, Wang X et al. Pregnancy outcome in women with Eisenmenger’s syndrome: A case series from west china. BMC Pregnancy Childbirths 2016; 16(1): 356. doi: 10.1186/ s12884-016-1153-z.

21. Presbitero P, Somerville J, Stone S et al. Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. Circulation 1994; 89(6): 2673– 2676.

22. Manalo-Estrella P, Barker AE. Histopathologic findings in human aortic media associated with pregnancy. Arch Pathol 1967; 83(4): 336– 341.

23. Ong KT, Perdu J, De Backer et al. Effect of celiprolol on prevention of cardiovascular events in vascular Ehlers-Danlos syndrome: A prospective randomised, open, blinded-endpoints trial. Lancet 2010; 376(9751): 1476– 1484. doi: 10.1016/ S0140-6736(10)60960-9.

24. Pyeritz RE. Maternal and fetal complications of pregnancy in the Marfan syndrome. Am J Med 1981; 71(5): 784– 790.

25. Matura LA, Ho VB, Rosing DR et al. Aortic dilatation and dissection in Turner syndrome. Circulation 2007; 116(15): 1663– 1670. doi: 10.1161/ CIRCULATIONAHA.106.685487.

26. Gravholt CH, Landin-Wilhelmsen K, Stockholm K et al. Clinical and epidemiological description of aortic dissection in Turner’s syndrome. Cardiol Young 2006; 16(5): 430– 436. doi: 10.1017/ S1047951106000928.