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Does congenital heart disease severely jeopardise family life and pregnancies? Obstetrical history of women with congenital heart disease in a single tertiary centre

Published online by Cambridge University Press:  08 March 2012

Marielle Morissens*
Affiliation:
Department of Cardiology, Brugmann University Hospital, Brussels, Belgium
Pierre Viart
Affiliation:
Department of Pediatric Cardiology, University Children's Hospital Queen Fabiola, Belgium
Laura Tecco
Affiliation:
Department of Gynecology, Brugmann University Hospital, Brussels, Belgium
Pierre Wauthy
Affiliation:
Department of Cardiac Surgery, Brugmann University Hospital, Brussels, Belgium
Simone Michiels
Affiliation:
Department of Pediatric Cardiology, University Children's Hospital Queen Fabiola, Belgium
Hugues Dessy
Affiliation:
Department of Pediatric Cardiology, University Children's Hospital Queen Fabiola, Belgium
Sophie Malekzadeh Milani
Affiliation:
Department of Pediatric Cardiology, University Children's Hospital Queen Fabiola, Belgium
Thierry Verbeet
Affiliation:
Department of Cardiology, Brugmann University Hospital, Brussels, Belgium
Jose Castro Rodriguez
Affiliation:
Department of Cardiology, Brugmann University Hospital, Brussels, Belgium
*
Correspondance to: Dr M. Morissens, Service de Cardiologie, Centre Hospitalier Universitaire Brugmann, 4 Place Arthur van Gehuchten, 1020 Bruxelles, Belgium. Tel: +32 2 477 26 79; Fax: +32 477 26 32; E-mail: marielle.morissens@chu-brugmann.be

Abstract

Aim

Women with congenital heart disease are often considered to be restricted in their obstetrical life and even their marital life. Our single-centre study aimed to determine the real-life situation of these women with regard to successful family life and any pregnancy complications they may experience.

Methods

From our database of adults with congenital heart disease, 160 of 178 women completed a questionnaire and had their files reviewed. They were classified into three groups according to their pregnancy risk – “good condition” group, no pregnancy restriction; “at-risk” group, pregnancy allowed with close follow-up at a tertiary centre; and “contraindicated” group, pregnancy inadvisable.

Results

The proportion of women in a relationship was 46% with no difference between the three groups. In the groups where pregnancy was allowed, 55% of women conceived a child. The total incidence of spontaneous abortion was 21%. The rate of caesarean section was 15%. The incidence of cardiac failure was 4.7%, arrhythmia 1.2%, endocarditis 1.2%, hypertension 2.4%, and preeclampsia 1.2%. Foetal complications included prematurity and/or low birth weight (9.5%) and one foetal malformation (0.82%).

Conclusion

Women with severe congenital heart disease are willing to start a family and are successful in this enterprise. Although the complication rate during pregnancy in congenital heart disease remains high, with good monitoring these pregnancies occur without severe complications and a low rate of medical abortion or caesarean section.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2012

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References

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Does congenital heart disease severely jeopardise family life and pregnancies? Obstetrical history of women with congenital heart disease in a single tertiary centre
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