Analysis on pregnancy outcomes and influencing factors after cardiac surgery under cardiopulmonary bypass in pregnancy

LI Yuxin; WANG Zhenzhong; ZHAO Junfei; ZHANG Chaolong; KE Yingjie; WANG Qiuji; ZHONG Lishan; PANG Shanwen; QIU Junqiang; LIU Yanli; ZHANG Chen; HUANG Huanlei

doi:10.3969/j.issn.1674-3806.2025.11.10

Abstract：Objective To analyze the pregnancy outcomes and influencing factors after cardiac surgery under cardiopulmonary bypass in pregnancy.Methods The clinical data of 56 patients who underwent cardiac surgery under cardiopulmonary bypass(CPB)in pregnancy in Department of Cardiac Surgery,Guangdong Provincial People's Hospital from January 2010 to December 2023 were retrospectively analyzed.According to whether the fetuses survived 1 week after surgery,the patients were divided into fetal survival group(45 patients)and fetal death group(11 patients).The clinical data were compared between the two groups.Multivariate logistic regression was used to analyze the influencing factors of fetal death.Results There were no maternal deaths among the 56 patients.Among the 45 patients of the fetal survival group,1 case belonged to a twin pregnancy.There were 11 cases in the fetal death group,all of whom were singleton pregnancies.The fetal mortality rate was 19.30％(11/57).The proportion of patients receiving metoprolol treatment during pregnancy in the fetal survival group was higher than that in the fetal death group,and the duration of operation and duration of CPB in the fetal survival group were shorter than those in the fetal death group,and the intraoperative blood loss in the fetal survival group was less than that in the fetal death group,and the perioperative blood transfusion rate in the fetal survival group was lower than that in the fetal death group,and the proportion of patients receiving atosiban treatment during the perioperative period in the fetal survival group was higher than that in the fetal death group,with statistically significant differences between the two groups(P＜0.05).The results of multivariate logistic regression analysis showed that perioperative blood transfusion was an independent risk factor for fetal death,while receiving metoprolol treatment during pregnancy and receiving atosiban treatment during the perioperative period were independent protective factors for inhibiting fetal death(P＜0.05).Conclusion Cardiac surgery under CPB during pregnancy poses a greater threat to the fetuses than to their mothers.Perioperative blood transfusion is an independent risk factor for fetal death.Receiving metoprolol treatment during pregnancy and receiving atosiban treatment during the perioperative period are independent protective factors for inhibiting fetal death.