Impact of Heart Disease on Maternal and Fetal Outcomes in Pregnant Women

2015 ◽  
Vol 116 (3) ◽  
pp. 474-480 ◽  
Author(s):  
Paraskevi Koutrolou-Sotiropoulou ◽  
Puja B. Parikh ◽  
Charles Miller ◽  
Fabio V. Lima ◽  
Javed Butler ◽  
...  
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Fetal Outcomes

Abstract 9816: Placenta Characteristics in Women With Heart Disease and Possible Impact on Fetal Outcomes

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Fabio V Lima ◽  
Paraskevi Koutrolou-Sotiropoulou ◽  
Puja B Parikh ◽  
Charles Miller ◽  
Cecilia Avila ◽  
...  
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Gestational Hypertension ◽  
Major Adverse Cardiovascular Events ◽  
Fetal Membrane ◽  
Premature Delivery ◽  
Fetal Outcomes ◽  
Clinical Events ◽  
Vascular Congestion ◽  
History Of

Background: Pregnant women with cardiomyopathy (CM) have higher rates of major adverse cardiovascular events (MACE) and fetal adverse clinical events (FACE) than those with other heart disease (HD) (congenital, valvular, or arrhythmia) and no HD, per a prior cohort. 1 Fetuses of mothers with CM are at higher risk for death, premature delivery, underweight, respiratory distress, and lower APGAR scores compared to those with HD. We sought to identify whether pregnant women with known CM or HD demonstrate a pattern of placental changes. Hypothesis: We anticipate pregnant women with a history of CM will have higher rates of abnormal placental characteristics compared with those with HD. Methods and results: We studied 86 pregnancies in women with CM or HD. Of these, 52 (60%) had HD and 34 (40%) had CM. Pathologic analyses were performed on 53 HD and 37 CM placentas. Gestational age in the HD and CM groups were different (38.6 vs 35.5, p < 0.001), as was the incidence of gestational hypertension (21 vs 50%, p 0.003). Among the maternal HD group, 44% had history of congenital heart disease, 33% prior corrective cardiac surgery and 31% had history of arrhythmia. Placental and fetal weight were lower among CM patients compared to those with HD (396 vs. 478 grams, p 0.007; and 2443 versus 3181 grams, p<0.001, respectively). Placentas of those patients with CM compared to those with HD were also more likely to have ischemic changes (65% vs. 34%, p 0.005) and be immature (60% vs. 9%, p<0.001). Pathological villous vascular congestion, fetal membrane abnormalities, fetal surface coloration abnormalities, umbilical cord abnormalities and extent of subchorionic fibrin and placenta calcification were not significantly different between the two groups. Conclusion: Abnormal placental pathologic characteristics such as low weight, ischemic changes and immaturity may contribute to fetal adverse events in pregnant women with CM. 1 Koutrolou-Sotiropoulou P, Parikh PB, Miller C, Lima FV, Butler J, Stergiopoulos K. Impact of Heart Disease on Maternal and Fetal Outcomes in Pregnant Women. Am J Cardiol In Press 2015.

Pregnancy outcomes in women with significant valve disease: a systematic review and meta-analysis

Heart ◽  
2020 ◽  
Vol 106 (7) ◽  
pp. 512-519 ◽  
Author(s):  
Robin Alexandra Ducas ◽  
David A Javier ◽  
Rohan D’Souza ◽  
Candice K Silversides ◽  
Wendy Tsang
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Pulmonary Oedema ◽  
Pregnancy Outcomes ◽  
Neonatal Death ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Fetal Outcomes

ObjectiveTo perform a systematic review and meta-analysis of maternal/fetal outcomes in pregnant women with moderate/severe native valvular heart disease (VHD) from medium/higher Human Development Index (HDI) countries.MethodsOvidSP platform databases were searched (1985-January 2019) to identify studies reporting pregnancy outcomes in women with moderate/severe VHD. The primary maternal outcome was maternal mortality. The primary fetal/neonatal outcome was stillbirth and neonatal death. Pooled incidences and 95% confidence intervals (CI) of maternal/fetal outcomes could only be calculated from studies involving mitral stenosis (MS) or aortic stenosis (AS).ResultsTwelve studies on 646 pregnancies were included. Pregnant women with severe MS had mortality rates of 3% (95% CI, 0% to 6%), pulmonary oedema 37% (23%–51%) and new/recurrent arrhythmias 16% (1%–25%). Their stillbirth, neonatal death and preterm birth rates were 4% (1%–7%), 2% (0%–4%), and 18% (7%–29%), respectively. Women with moderate MS had mortality rates of 1%(0%–2%), pulmonary oedema 18% (2%–33%), new/recurrent arrhythmias 5% (1%–9%), stillbirth 2% (1%–4%) and preterm birth 10%(2%–17%).Pregnant women with severe AS had a risk of mortality of 2% (0%–5%), pulmonary oedema 9% (2%–15%), and new/recurrent arrhythmias 4% (0%–7%). Their stillbirth, neonatal death and preterm birth rates were 2% (0%–5%), 3% (0%–6%) and 14%(4%–24%), respectively. No maternal/neonatal deaths were reported in moderate AS, however women experienced pulmonary oedema (8%; 0%–20%), new/recurrent arrhythmias (2%; 0%–5%), and preterm birth (13%; 6%–20%).ConclusionsWomen with moderate/severe MS and AS are at risk for adverse maternal and fetal/neonatal outcomes. They should receive preconception counseling and pregnancy care by teams with pregnancy and heart disease experience.

scholarly journals COVID-19 in pregnant women with heart diseases. Adverse maternal and fetal outcomes. Case series from InCor registry of Pregnancy and Heart Disease

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M R Kirschbaum ◽  
M S Devido ◽  
E Azeka ◽  
L M M F Demarchi ◽  
J S Santos ◽  
...  
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Heart Diseases ◽  
Case Series ◽  
Childbearing Age ◽  
Fetal Outcomes ◽  
Worst Case ◽  
Increased Risk ◽  
Co Morbidity ◽  
Pregnancy And Heart Disease

Abstract Background Heart disease is the leading non-obstetric cause of maternal death during pregnancy. In this field, the emergence of pandemic COVID-19 has caused the worst-case scenario considering that pregnant women are more susceptible to viral infections, and preexisting cardiac disease is the most prevalent co-morbidity among COVID-19 deaths. Purpose To assess the maternal and fetal outcomes of COVID-19 during pregnancy of women with heart diseases. Methods During the year 2020, among 82 pregnant women with heart disease followed consecutively at the Instituto do Coração-InCor, seven of them with an average age of 33.2 years had COVID-19 during their pregnancies. The underlying heart diseases were rheumatic valve disease (5 pt), congenital heart disease (1 pt) and one case with acute myocarditis, without preexisting cardiopathy. The prescription (antibiotics, inotropes, corticosteroids and others) used was according to the clinical conditions required for each patient, however subcutaneous or intravenous heparin was used in all patients. Results Only one case had an uneventful maternal-fetal course, the other six women required hospitalization / ICU for an average of 25.3 days, including the need for mechanical ventilation in two of them. Serious complications were related to respiratory failure (ADRS), recurrent atrial flutter with hemodynamic instability, acute pulmonary edema, and cardiogenic shock associated with sepsis which caused two maternal deaths. There were two emergency mitral valve interventional, percutaneous balloon valvuloplasty and valve bioprosthesis replacement, respectively. There were five premature births with an average gestational age of 34.2 weeks of gestation, which resulted in one stillbirth. Pathological findings of three placental and the six-months follow-up of the babies did not confirm vertical transmission of COVID-19. Conclusions The uncertain evolution given of the overlapping complications of three conditions – COVID-19, pregnancy, and heart disease – implies an increased risk for women with heart diseases of childbearing age, for whom pregnancy should be discouraged and planned after vaccination FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Maternal and fetal outcomes in pregnant females with rheumatic heart disease

2021 ◽  
Author(s):  
Roopali Khanna ◽  
Deepti Chandra ◽  
Sangeeta Yadav ◽  
Ankit Sahu ◽  
Neeta Singh ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Fetal Outcomes ◽  
Pregnant Females ◽  
Rheumatic Heart

scholarly journals Use of Routine Echocardiographic Screening for Structural Heart Disease in At-Risk Pregnant Women in India

2020 ◽  
Author(s):  
Amisha Patel ◽  
Lauren S. Ranard ◽  
Nicole Aranoff ◽  
Hussein Rahim ◽  
Roja Vanukuru ◽  
...  
Keyword(s):  
At Risk ◽  
Heart Disease ◽  
Pregnant Women ◽  
Structural Heart Disease ◽  
Women In India

scholarly journals AB0747 MATERNAL AND FETAL OUTCOMES IN PREGNANT WOMEN WITH JUVENILE IDIOPATHIC ARTHRITIS: A SYSTEMATIC LITERATURE REVIEW

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1402.1-1402
Author(s):  
R. Pinheiro Torres ◽  
M. H. Fernandes Lourenco ◽  
A. Neto ◽  
F. Pimentel Dos Santos ◽  
I. Silva ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Literature Review ◽  
Pregnant Women ◽  
Systematic Literature Review ◽  
English Language ◽  
Placenta Previa ◽  
Bibliographic Databases ◽  
Fetal Outcomes ◽  
Term Birth ◽  
Increased Risk

Background:Juvenile idiopathic arthritis (JIA), one of the most common chronic diseases in children, can be classified in seven different categories according to its onset presentation. Concerns about pregnancy outcomes play a secondary role in disease approach. However, recent data showed an increased risk of pre-term birth in women with JIA instead the small patient samples analysed.Objectives:In this review, our aim is to describe the current available knowledge on JIA adverse, maternal and fetal, outcomes.Methods:A systematic literature review was conducted since January of 2000 until December 2020, by searching the PubMed and Embase bibliographic databases. The search was limited to articles in English language, presenting a comparator group (healthy individuals or patients without known auto-immune rheumatic diseases) and at least one clinical outcome of interest. Two independent reviewers screened the titles and abstracts followed by a full-text review to assess papers regarding their eligibility.Results:Ten observational studies out of 1560 references, fulfilled the inclusion criteria, of which, 9 were retrospective and 1 prospective. A total of 6.214 women with JIA (with 6.811 pregnancies) and 18.659.513 healthy controls (with 21.339.194 pregnancies) were included in this review.Concerning maternal outcomes, delivery by caesarian section (CS) was more frequent among JIA women (in 4 out of 6 studies). Pre-eclampsia was referred in 3 out of 6 studies and a higher risk of vaginal bleeding and placenta previa in one additional study. No study found an increased risk for gestational diabetes or hypertension in pregnant women with JIA.Regarding fetal outcomes, 8 studies revealed significantly increased of pre-term birth (only in first births in one study) but one study didn’t show any increased risk. Two studies showed a higher risk of small gestational age (SGA) and in another 2, increased risk for low birth weight (LBW). No evidence of increased risk of major congenital malformations.Conclusion:This systematic review suggests an increased risk for pre-eclampsia, preterm birth, delivery by CS, SGA and LBW, among pregnant women with JIA. Conclusions should be carefully interpreted, giving the heterogeneity of studied populations regarding demography, disease type, disease activity, and prescribed medication.Disclosure of Interests:None declared

scholarly journals ADVERSE CARDIOVASCULAR AND OBSTETRIC DELIVERY COMPLICATIONS IN PREGNANT WOMEN WITH VALVULAR HEART DISEASE

2021 ◽  
Vol 77 (18) ◽  
pp. 3389
Author(s):  
Anum Minhas ◽  
Faisal Rahman ◽  
Nicole Gavin ◽  
Ari Cedars ◽  
Arthur Vaught ◽  
...  
Keyword(s):  
Heart Disease ◽  
Pregnant Women ◽  
Valvular Heart Disease ◽  
Obstetric Delivery ◽  
Delivery Complications

scholarly journals An Increased Adverse Fetal Outcome Has Been Observed among Teen Pregnant Women in Rural Eastern Ethiopia: A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199915
Author(s):  
Haymanot Mezmur ◽  
Nega Assefa ◽  
Tadesse Alemayehu
Keyword(s):  
Pregnant Women ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
World Health ◽  
Adult Women ◽  
Sectional Study ◽  
Fetal Outcomes ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
Adverse Fetal Outcome

Background: According to the World Health Organization, teenage pregnancies are high-risk due to increased risks of fetal and infant morbidity and mortality. This study compares adverse fetal outcomes between teen and adult pregnant women from rural Eastern Ethiopia. Methods: Institutional-based cross-sectional study was conducted among women visiting maternity units from surrounding rural areas. A total of 481 teenagers (13-19 years old) and 481 adults (20-34 years old) women with a singleton pregnancy were included in the study. Two hospitals and 3 health centers were selected in Eastern Hararghe Zone, Eastern Ethiopia. Comparative analysis was carried out using the log-binomial regression model to identify factors associated with adverse fetal outcomes in both categories. The results are reported in adjusted prevalence ratios with 95% confidence intervals. Results: High proportion of adverse fetal outcome was observed among teenage women than adult (34.9% vs 21%). Statistically significant difference ( P < .05) in the proportion of low birth weight (21.1% vs 9.3%), preterm birth (18.7% vs 10.6%), APGAR score at 5th minute (9.3% vs 4%) were found in teenagers compared to adult women. Antenatal care attendance (APR = 0.44; 95% CI: 0.23, 0.86); eclampsia (APR = 1.96; 95% CI: 1.26, 3.06); pre-eclampsia (APR = 1.73; 95% CI: 1.12, 2.67); and wealth index (rich) (APR = 0.55; 95% CI: 0.32, 0.94) were significantly associated with adverse fetal outcomes among the teenage women. Whereas intimate partner violence (APR = 2.22; 95% CI: 1.26, 3.90); preeclampsia (APR = 3.05; 95% CI: 1.61, 5.69); antepartum hemorrhage (APR = 2.77; 95% CI: 1.73, 4.46); and hyperemesis gravderm (APR = 1.75; 95% CI: 1.09, 2.79) were significantly associated with adverse fatal outcomes among the adult women. Conclusion: teenage pregnancy is associated with a high rate of adverse fetal outcomes. Early identification and treatment of problems during antenatal follow-up should be the mainstay to avert the massive adverse fetal effects.

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