Pregnancy and Maternal Congenital Heart Disease

E-chocardiography Journal: Alphabetical List / Chronological List / Images / Home Page

Guidelines in Spanish. Artículos especiales. Volumen 53, Número 11, Noviembre 2000 Rev Esp Cardiol 2000; 53: 1474 - 1495

Am J Obstet Gynecol. 1987 Feb;156(2):313-22.
Erratum in: Am J Obstet Gynecol 1987 May;156(5):1361.
Congenital heart disease in pregnancy: short- and long-term implications.
Shime J, Mocarski EJ, Hastings D, Webb GD, McLaughlin PR.

One hundred forty-four pregnancies that occurred in 74 patients with congenital heart disease at the Toronto General Hospital between 1975 and 1986 were reviewed. The patients were divided into two groups, those with acyanotic lesions and those with cyanotic lesions. Maternal and fetal outcomes in these two groups were compared. Patients with cyanotic lesions developed significantly more congestive heart failure and deteriorated more often in functional cardiac status than those with acyanotic lesions (p less than 0.005). Women with obstructive lesions had a higher incidence of pregnancy-induced hypertension than our general population (p less than 0.005). There was one maternal death in the puerperium in a woman with Eisenmenger's syndrome. Preterm births were more frequent in the cyanotic group (p less than 0.01) as were small for gestational age infants (p less than 0.005). In the cyanotic group the mean birth weight was 900 gm less than that in the acyanotic group (p less than 0.005). The major benefits of corrective cardiac surgery were in the cyanotic group and consisted of fewer spontaneous abortions (p less than 0.01) and small for gestational age infants (p less than 0.02) and more term births (p less than 0.01). Long-term follow-up revealed that 19.2% of women with acyanotic lesions had significant cardiac developments, compared with 90% in the cyanotic group (p less than 0.005). One of 87 infants (1.1%) had congenital heart disease and two had Marfan's syndrome.

J Reprod Med. 1986 May;31(5):343-7.
Outcome of pregnancy in 110 patients with organic heart disease.
Katz M, Pinko A, Lurio S, Pak I.

Organic heart disease is still one of the main causes of maternal and fetal mortality. The outcome of pregnancy in 110 patients with organic heart disease ranging from class I to IV (New York Heart Association Classification) was studied. The incidence of intrauterine growth retardation in the study group was examined with regard to severity of the disease. Birth weight was compared to that in a matched control group, and no statistically significant difference between the two groups was found.

Am J Cardiol. 1982 Sep;50(3):641-51.
Pregnancy and its outcome in women with and without surgical treatment of congenital heart disease.
Whittemore R, Hobbins JC, Engle MA.

In the state of Connecticut, 233 women with congenital heart defects were prospectively followed up through 482 pregnancies that resulted in 372 infants who were examined frequently during their first 3 years of life. Approximately half of the women had undergone cardiac surgery and they were compared with the women without operation. There was no maternal mortality, and no patient had infective endocarditis, brain abscess or a cerebrovascular accident. The proportion of pregnancies resulting in live births did not differ significantly in mothers with and without cardiac surgery; the average live birth rate was 77 percent in all. However, the number and size of live-born infants was much greater in mothers who had become acyanotic as a result of reparative surgery than in the still cyanotic women, whether or not they had had palliative surgery. In cyanotic women, placental size was abnormally large in relation to birth weight, which was abnormally low. When the mothers were classified according to cardiac function, there was a significant difference between the number of infants born alive to mothers in good to excellent status and the number born to mothers in fair to poor condition. The latter had a significant increase in interrupted pregnancies as well as in cardiovascular complications during pregnancy. The total group had a 16.1 percent incidence rate of infants with congenital heart disease. This rate was corrected to 14.2 percent by removal of seven mothers, two with Noonan's syndrome, one with hypertrophic cardiomyopathy and four with a family history of congenital heart defects.

Singapore Med J. 1975 Jun;16(2):97-9.
Congenital heart disease in pregnancy.
Chew PC, Chew SC, Lee YK, Ratnam SS.

Med J Aust. 1971; 2:277-281
Heart Disease and Pregnancy at the Royal Women's Hospital.
Etheridge MJ, Pepperell RJ.

Med J Aust. 1970 May 30;1(22):1086-8.
Congenital heart disease and pregnancy.
Neilson G, Galea EG, Blunt A.

Clin Obstet Gynecol. 1968 Dec;11(4):1048-63.
Congenital heart disease and pregnancy.
Schaefer G, Arditi LI, Solomon HA, Ringland JE.

Circulation 24 : 1003, 1961
Outcome of Pregnancy in Congenital Heart disease.
Neill, C.A., Galea, E. G., and Blunt, A.

Back to E-chocardiography Home Page.

The contents and links on this page were last verified on May 17, 2006.