Clinical characteristics and pregnancy outcomes of women with congenital heart disease

Li Qiangqiang; Gu Hong; Liu Tianyang; Zhang Dan; Xu Zhuoyuan; Liu Qian; Zhang Jun; Li Yanna

doi:10.3760/cma.j.issn.1673-4777.2017.12.009

Abstract：Objective To observe clinical characteristics and pregnancy outcomes in women with congenital heart disease(CHD).Methods Totally 660 pregnant women with CHD who were admitted at Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University from January 2010 to September 2016 were retrospectively analyzed.Clinical features,pregnancy outcones,adverse events,maternal cardiac complications and neonatal complications were analyzed.Results The average age of pregnant women was (28 ± 5)years (16-44 years);the median gestational age was 37 weeks (3-41 weeks).Two hundred and fourteen women had spontaneous abortion or induced abortion before 28 gestational weeks;446 cases had complete pregnancy.Incidence of severe adverse events was 2.2％ (10/446);maternal mortality rate was 1.1％ (5/446);incidence of cardiac complications was 10.3％ (46/446).Patients with simple left-to-right shunt without pulmonary arterial hypertension and corrected CHD without residual deformity had low pregnancy risk;patients with Eisenmenger's syndrome had high risk of maternal death and cardiac complications.In 448 newborns,incidence of neonatal complications was 19.0％ (85/448);the incidence of neonatal complications in maternal cyanotic CHD was the highest[72.7％ (8/11)];incidence of neonatal heart malformation was 2.9％ (13/448).Conclusions There are different pregnancy outcomes and risk of cardiac complications in mother with different CHD.Patients with simple left-to-right shunt without pulmonary arterial hypertension and corrected CHD without residual deformity can have normal pregnancy and delivery;Eisenmenger's syndrome and cyanotic CHD can cause high pregnancy risk and early termination is recommended.