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
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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