| Autor: |
Larisa G Tereshchenko, Joanna Ghobrial, Margaret Fuchs, Yasmine Wazni, Christopher Sefton, Betemariam Sharew, Elizabeth Ghandakly, Patricia Blazevic, Nandini Mehra, Justin R Lappen, Cara D Dolin, Adina Kern-Goldberger, Stephen Bacak, Kenneth Zahka, Amy McKenney, Katherine Singh, Peter F Aziz |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
Open Heart, Vol 11, Iss 2 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2053-3624 |
| DOI: |
10.1136/openhrt-2024-002768 |
| Popis: |
Background Pregnant patients with single ventricle (SV) physiology carry a high risk of spontaneous pregnancy loss (SPL), yet the clinical factors contributing to this risk are not well defined.Methods Single-centre retrospective study of pregnant patients with SV physiology seen in cardio-obstetrics clinic over the past 20 years with chart review of their obstetric history. Patients without a known pregnancy outcome were excluded. Univariable Bayesian panel-data random effects logit was used to model the risk of SPL.Results The study included 20 patients with 44 pregnancies, 20 live births, 21 SPL and 3 elective abortions. All had Fontan palliation except for two with Waterston and Glenn shunts. 10 (50%) had a single right ventricle (RV). 14 (70%) had moderate or severe atrioventricular valve regurgitation (AVVR). Atrial arrhythmias were present in 16 (80%), Fontan-associated liver disease (FALD) in 15 (75%) and FALD stage 4 in 9 (45%). 12 (60%) were on anticoagulation. Average first-trimester oxygen saturation was 93.8% for live births and 90.8% for SPL. The following factors were associated with higher odds of SPL: RV morphology (OR 1.72 (95% credible interval (CrI) 1.0008–2.70)), moderate or severe AVVR (OR 1.64 (95% CrI 1.003–2.71)) and reduced first-trimester oxygen saturation (OR 1.83 (95% CrI 1.03–2.71) for each per cent decrease in O2 saturation.Conclusion Pregnant patients with SV physiology, particularly those with RV morphology, moderate or severe AVVR, and lower first-trimester oxygen saturations, have a higher risk of SPL. Identifying these clinical risk factors can guide preconception counselling by the cardio-obstetrics team. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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