Maternal and fetal outcomes in pregnancy complicated with Eisenmenger syndrome
Autor: | Chinami Horiuchi, Jun Yoshimatsu, Tomoaki Ikeda, Norifumi Nakanishi, Takekazu Miyoshi, Koichiro Niwa, Takeshi Ogo, Reiko Neki, Naoko Iwanaga, Shinji Katsurahgi, Kaoru Yamanaka, Hiroaki Tanaka, Chizuko Kamiya, Yaemi Takagi |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Adult
Heart Septal Defects Ventricular Cardiac Catheterization medicine.medical_specialty congenital hereditary and neonatal diseases and abnormalities Pregnancy High-Risk Pregnancy Complications Cardiovascular lcsh:Gynecology and obstetrics Heart Septal Defects Atrial 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors Ductus arteriosus Heart rate Humans Medicine Abortion Therapeutic Ductus Arteriosus Patent lcsh:RG1-991 Retrospective Studies Heart Failure Fetus 030219 obstetrics & reproductive medicine Ejection fraction Cesarean Section business.industry Obstetrics Obstetrics and Gynecology Retrospective cohort study Eisenmenger Complex medicine.disease Abortion Spontaneous medicine.anatomical_structure Echocardiography Eisenmenger syndrome Gestation Female business |
Zdroj: | Taiwanese Journal of Obstetrics & Gynecology, Vol 58, Iss 2, Pp 183-187 (2019) |
ISSN: | 1028-4559 |
Popis: | Objective: The goal of the study was to clarify the risk factors for pregnancy complicated with Eisenmenger syndrome (ES). Materials and methods: A retrospective study was performed in 15 patients with ES who were managed throughout pregnancy at one institution from 1982 to 2013. Cases associated with congenital heart diseases other than atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) were excluded. Results: The congenital heart diseases in ES included ASD (n = 3), VSD (n = 9), and PDA (n = 3). Ten women chose termination and 5 continued with their pregnancies. In the 5 continuation cases (PDA 1, VSD 4), worsening of cyanosis, exertional fatigue and dyspnea appeared between 25 and 30 weeks gestation and cesarean section was performed at 30 (28–33) weeks. LVEF, PaO2, and SpO2 decreased and heart rate increased significantly from before pregnancy to 25–30 weeks gestation. From before to during the pregnancy, there were no significant changes in mean PABP or pulmonary vascular resistance (PVR) in four cases with data (582–592, 885 to 868, 1280 to 1291, 1476–1522 dyn × s/cm2). PVR at conception had a negative relationship with delivery weeks. NYHA classes before, during and 1 year after pregnancy were II, III and II. In one recent case, epoprostenol and tadalafil were administered during pregnancy. Conclusions: Pregnancy with ES has a high risk due to hypooxygenation, cyanosis, and cardiac failure, which can appear as common complications as early as the 2nd trimester. Early interventions with meticulous care are required for these complications during pregnancy and delivery. Keywords: Cardiac failure, Cyanosis, Eisenmenger syndrome, Pregnancy |
Databáze: | OpenAIRE |
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