Birth weight in pregnancies complicated by maternal heart disease

Heart ◽  
2018 ◽  
pp. heartjnl-2018-313551 ◽  
Author(s):  
Matthew Cauldwell ◽  
Philip Steer ◽  
Monique Sterrenburg ◽  
Suzanne Wallace ◽  
Gemma Malin ◽  
...  
Keyword(s):  
Heart Disease ◽  
Birth Weight ◽  
Gestational Age ◽  
Heart Valves ◽  
Beta Blockers ◽  
Prosthetic Heart Valves ◽  
Cardiac Lesion ◽  
Systemic Right Ventricle ◽  
Almost All ◽  
Median Birth Weight

ObjectiveTo assess median and percentile birthweight distribution in women with various groups of heart disease relative to a contemporaneous comparison group.MethodsData on birth weight and gestational age were collected from 1321 pregnancies ≥24 weeks’ gestation in 1053 women with heart disease from seven UK maternity units. Women were assigned to one of 16 groups according to their cardiac lesion. In units where it was possible, data on two births, one delivering before and one after index cases, were collected, giving 2307 comparators. Birthweight percentiles (corrected for gestational age, sex and parity) were calculated using Aberdeen norms. We assessed the association of birth weight with cardiac lesion, maternal hypoxaemia (saturations <90%), systemic ventricular function and beta-blockers.Results1321 pregnancies in women with heart disease and 2307 comparators were studied. Almost all groups with heart disease had lower median and percentile birth weights than comparators, significantly in 10 groups, the biggest effect seen in women with Fontan circulation, pulmonary hypertension, prosthetic heart valves, systemic right ventricle, Marfan syndrome, repaired tetralogy of Fallot and cardiomyopathy (in that order). In 307 pregnancies, women took beta-blockers; median birth weight adjusted for maternal age, parity and the effect of the cardiac lesion was 3116.7 g (IQR 790.4) when beta-blockers were used and 3354.3 g (IQR 634.1) when they were not (p<0.001). 17 women had saturations <90%, and median birth weight was significantly lower, 3105.4 g (IQR 1288.9) versus 3387.7 g (IQR 729.8) (p=0.006).ConclusionOur findings identify specific groups of women with heart disease at risk of having a small baby.

scholarly journals Bioprosthetic Heart Valves: Impact of Implantation on Biomaterials

2013 ◽  
Vol 2013 ◽  
pp. 1-14 ◽  
Author(s):  
Pooja Singhal ◽  
Adriana Luk ◽  
Jagdish Butany
Keyword(s):  
Heart Disease ◽  
Heart Valves ◽  
Prosthetic Heart Valves ◽  
Bioprosthetic Heart Valves ◽  
Modes Of Failure ◽  
Mechanical Valves ◽  
Different Types ◽  
Patient Groups ◽  
Bioprosthetic Valves

Prosthetic heart valves are commonly used in the treatment of valvular heart disease. Mechanical valves are more durable than the bioprosthetic valves; however, the need for long-term anticoagulant therapy renders them unsuitable for some patient groups. In this paper we discuss the different types and models of bioprosthesis, and in particular, pericardial bioprosthesis. We also discuss the preimplantation preparation processes, as well as their postimplantation changes and modes of failure.

Congenital Heart Disease in non-Diabetic Large-for-Gestational-Age (LGA) Neonates

2020 ◽  
Vol 20 ◽  
Author(s):  
Majid Firouzi ◽  
Hamidreza Sherkatolabbasieh ◽  
Alireza Nezami ◽  
Shiva Shafizadeh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Birth Weight ◽  
Gestational Age ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Large For Gestational Age ◽  
Congenital Heart Diseases ◽  
Increased Risk ◽  
Heart Abnormalities

Background: Congenital heart diseases are the most prevalent congenital abnormalities in the neonates, caused by the environmental and genetic factors and contribute to the leading cause of death. The aim of this study is to evaluate the relationship between neonates with large for gestational age and increased risk of congenital heart diseases among nondiabetic mothers. Methods: In this study, 179 neonates with large for gestational age in Khorramabad were enrolled where heart abnormalities were evaluated using echocardiography. Results: 87 neonates had more than 4000 g of the birth weight with no heart abnormalities and 92 (51%) macrosomic neonates had congenital heart diseases. Statistical analysis revealed that there was a significant relationship between birth weight and increased risk of acquiring congenital heart disease between the two groups. There was no significant relationship between birth weight, maternal age, gender, labor type and blood group between the two groups. The highest incidence of congenital heart anomalies was related to 38% of arterial septal defect (ASD) and 15.2% of ASD and VSD, respectively Conclusion: The most prevalent abnormality was arterial septal ASD. None of these abnormalities were associated with maternal age, birth weight and neonate gender. Future studies for congenital heart disease and neonatal birth weight are therefore, recommended.

Dynamic Numerical and Experimental Evaluation of Trileaflet Polymer Prosthetic Heart Valves

2011 ◽  
Author(s):  
Thomas E. Claiborne ◽  
Michalis Xenos ◽  
Gaurav Girdhar ◽  
Yared Alemu ◽  
Jawaad Sheriff ◽  
...  
Keyword(s):  
Public Health ◽  
Heart Disease ◽  
Artificial Heart ◽  
Heart Valves ◽  
Prosthetic Heart Valve ◽  
Total Artificial Heart ◽  
Public Health Issue ◽  
Prosthetic Heart Valves ◽  
Open Heart ◽  
Significant Public Health

Valvular heart disease (VHD) continues to be a significant public health issue with an estimated 1–2% of the population affected [1]. Currently, VDH is primarily treated at the end stages with open-heart surgical replacement of the diseased valve with either a tissue or mechanical prosthetic heart valve (PHV), each having deficiencies including low durability and high thrombosis respectively. Polymer trileaflet PHVs have been designed to mimic the native aortic valve (AV) hemodynamics while being more durable and less thrombogenic than current PHVs. Recent advances in polymers and its applications for polymer PHVs, including transcatheter PHVs or use in the Total Artificial Heart (TAH) (Fig. 1), encourage further research and development [2–4]. Paramount to polymer PHV progress is proving equivalence to commercially available FDA approved PHVs.

Peritoneal Drainage as the Initial Management of Intestinal Perforation in Premature Infants

2014 ◽  
Vol 80 (9) ◽  
pp. 851-854 ◽  
Author(s):  
Sean M. Stokes ◽  
Joseph A. Iocono ◽  
John M. Draus
Keyword(s):  
Birth Weight ◽  
Median Time ◽  
Premature Infants ◽  
Gestational Age ◽  
Intestinal Perforation ◽  
Peritoneal Drainage ◽  
Definitive Therapy ◽  
Group 2 ◽  
Median Birth Weight ◽  
Group 1

Complicated necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are major causes of mortality. We hypothesized that peritoneal drainage (PD) is more efficacious in SIP. Newborn infants with intestinal perforation treated with PD at our institution between 2007 and 2012 were divided into two groups: Group 1, infants with complicated NEC (n = 19), and Group 2, infants with SIP (n = 15). In Group 1, median birth weight was 705 g; median gestational age was 25.9 weeks. Median age at PD was 24 days. Six required laparotomy. Median time from PD to enteral feeds was 22.5 days. In Group 2, median birth weight was 685 g; median gestational age was 25.3 weeks. Median age at PD was 5 days. Two required laparotomy. Median time from PD to enteral feeds was 16 days. In Group 1, eight patients survived to discharge; median length of hospital stay (LOS) was 104.5 days. In Group 2, eight survived; median LOS was 109.5 days. Neither outcome was statistically significant ( P = 0.73 and 0.878, respectively). Management of premature infants with intestinal perforation remains challenging. Mortality is high. Between our cohorts, there were no differences in regard to PD as definitive therapy, survival, and LOS.

scholarly journals Platelet Survival Measurement - Clinical Results.

1977 ◽  
Author(s):  
E. Genton
Keyword(s):  
Heart Disease ◽  
Valvular Heart Disease ◽  
Heart Valves ◽  
Clinical Results ◽  
Prosthetic Heart Valves ◽  
Drug Reactions ◽  
Recurrent Thrombosis ◽  
Platelet Survival ◽  
Thrombotic Complications ◽  
Foreign Surface

Platelet survival (PS) time has been studied in patients in a variety of clinical circumstances associated with abnormal numbers of platelets, suspected thrombotic process, or after platelet suppressing drug administration.In conditions with thrombocytopenia, PS may differentiate decreased platelet production (ineffective thrombopoiesis or megakaryocyte hypoplasia) where PS is normal from increased destruction of platelets where PS is shortened. Increased destruction may arise from: extrinsic mechanisms, e.g. immunologic (ITP-SLE-drug reactions) or abnormal surface (diseased endothelium or foreign surface) are associated with short PS, often to extreme degrees; intrinsic platelet defect (Wiskott-Aldrich Syndrome), where autologous PS is shortened and isologous PS is normal.In thrombotic disorders, PS is shortened during active thrombosis and may be chronically shortened in conditions with recurrent thrombosis (homocystinemia, atheroslcerosis, valvular heart disease). The test may prove useful in prognosis (e.g. valvular heart disease patients with shortened platelet survival may have higher risk of embolic events than with normal PS).Only a few platelet suppressing drugs (including sulfinpyrazone and dipyridamole) affect a shortened platelet survival time. These reduce thrombosis in patients with prosthetic heart valves and silastic AV shunts, suggesting PS may identify useful drugs.Thus, PS may differentiate disease conditions associated with abnormal platelets, predict the course of patients at high risk of thrombotic complications, and identify clinically useful platelet suppressing drugs, or serve as a monitor for measuring effects of drug treatment.

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