Pregnancy outcomes in women with Ebstein's anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC).

Autor:	van der Zande JA; Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.; Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands., Tutarel O; Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre, Munich, Germany., Ramlakhan KP; Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands., van der Bosch AE; Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands., Bordese R; Department of Pediatric Cardiology and Congenital Heart Disease, Regina Margherita Children's Hospital, Turin, Italy., Zengin E; Department of Cardiology, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Hamburg, Germany., Wagner WE; Department of Cardiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA., de Sousa L; Department of Cardiology, Hospital de Santa Marta, Lisboa, Portugal., Clifford P; Department of Cardiology, Imperial College Healthcare NHS Trust, London, UK., Johnson MR; Department of Obstetric Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK., Hall R; Department of Cardiology, University of East Anglia Norwich Medical School, Norwich, UK., Roos-Hesselink JW; Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands j.roos@erasmusmc.nl.
Jazyk:	angličtina
Zdroj:	Open heart [Open Heart] 2023 Aug; Vol. 10 (2).
DOI:	10.1136/openhrt-2023-002406
Abstrakt:	Objective: Ebstein's anomaly is a rare congenital cardiac condition and data regarding pregnancy outcomes in this patient group are scarce. We evaluated the maternal and perinatal risks of pregnancy in 81 women with Ebstein's anomaly. Methods: The Registry of Pregnancy and Cardiac disease is a prospective global registry of pregnancies in women with structural cardiac disease. Pregnancy outcomes in women with Ebstein's anomaly were examined. The primary outcome was the occurrence of a major adverse cardiac event (MACE) defined as maternal mortality, heart failure, arrhythmia, thromboembolic event or endocarditis. Secondary endpoints were obstetric and perinatal outcomes and the influence of pregnancy on tricuspid valve regurgitation as well as right atrial and ventricular dimensions. Results: In the 81 women with Ebstein's anomaly (mean age 29.7±6.1 years, 46.9% nulliparous), MACE occurred in 8 (9.9%) pregnancies, mostly heart failure (n=6). There were no maternal deaths. Prepregnancy signs of heart failure were predictive for MACE. Almost half of the women were delivered by caesarean section (45.7%) and preterm delivery occurred in 24.7%. Neonatal mortality was 2.5% and 4.9% of the infants had congenital heart disease. In the subgroup in which prepregnancy and postpregnancy data were available, there was no difference in tricuspid valve regurgitation grade or right atrial and ventricular dimensions before and after pregnancy. Conclusions: Most women with Ebstein's anomaly tolerate pregnancy well, but women with prepregnancy signs of heart failure are at higher risk for MACE during pregnancy and should be counselled accordingly. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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