scholarly journals High Maternal Neonatal Mortality and Morbidity in Pregnancy with Eisenmenger Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Erry Gumilar Dachlan ◽  
Amirah ◽  
Nareswari Cininta ◽  
Rizky Pranadyan ◽  
Alisia Yuana Putri ◽  
...  
Keyword(s):  
Heart Disease ◽  
Neonatal Mortality ◽  
Maternal Death ◽  
Pregnancy Outcomes ◽  
Septal Defect ◽  
Defect Size ◽  
Eisenmenger Syndrome ◽  
Large Defect ◽  
Mortality And Morbidity ◽  
Death Cases

Objectives. This study is aimed at evaluating the maternal and perinatal characteristics and pregnancy outcomes of ES. Material and Methods. This is a retrospective cohort study of pregnancy with Eisenmenger syndrome (ES) in Dr. Soetomo Hospital from January 2018 to December 2019. Total sampling size was obtained. We collected all baseline maternal-perinatal characteristic data, cardiac status, and pregnancy outcomes as primary outcomes. The maternal death cases were also evaluated, and we compared characteristics based on defect size (< or >3 cm). Results. During study periods, we collected 18 cases with ES from a total of 152 pregnancies with heart disease. The underlying heart disease type includes atrial septal defect (ASD), ventricle septal defect (VSD), and patent ductus arteriosus (PDA). All cases suffered pulmonary hypertension (PH), 3 cases moderate, and 15 cases as severe. 94% of cases fall into heart failure (DC FC NYHA III-IV) during treatment. The majority of cases are delivered by cesarean section (88.9%). Pregnancy complications found include preterm birth (78%), low birthweight (94%), intrauterine growth restriction (55%), oligohydramnios (16%), severe preeclampsia (33%), and placenta previa (5.5%). Large defect group has an older maternal ages ( 30.18 ± 4.60 vs. 24.15 ± 2.75 ; p = 0.002 ), higher clinical sign (100 vs. 40%, p = 0.003 ), and higher preterm delivery rate (100% vs. 69%, p = 0.047 ) compared to small defect groups. The R to L or bidirectional shunt is significantly higher at the large defect group (13 vs. 5 cases, p = 0.006 , 95% confidence interval: -1.156 to -0.228). There were seven maternal death cases caused by shock cardiogenic. Conclusions. Pregnancy with ES is still associated with very high maternal neonatal mortality and morbidity. The larger defect size is correlated with clinical performances and pregnancy outcomes. Effective preconception counseling is the best strategy to reduce the risk of maternal and neonatal death in ES women.

Clinical course in children and adolescents with ventricular septal defect

2019 ◽  
Vol 27 (7) ◽  
pp. 529-534
Author(s):  
Noor Mohammad Noori ◽  
Alireza Teimouri
Keyword(s):  
Pulmonary Hypertension ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Clinical Course ◽  
Defect Size ◽  
Eisenmenger Syndrome ◽  
Ventricular Septal Defects ◽  
Laboratory Findings ◽  
Septal Defects

Background Ventricular septal defect, the most common congenital heart defect, is characterized by an opening between the ventricles. This study aimed to evaluate the clinical course and associations between the characteristics of ventricular septal defect. Methods This cross-sectional study was conducted on 1498 children with ventricular septal defects, aged <19 years, who were referred to our center between 2003 and 2018. The diagnosis was suspected from a combination of clinical and laboratory findings, and confirmed by transthoracic echocardiography. Results Of the 1498 children, 54.9% were boys, 78.4% of defects were perimembranous, 30.4% of patients had pulmonary hypertension, 67.5% had regular follow-up, and 76 (5.1%) had complications including 28 (1.9%) with Eisenmenger syndrome; 10 died due to Eisenmenger syndrome during follow-up. The defects closed spontaneously in 38.9% and after surgery in 20.9%. Boys tended to have more perimembranous, inlet, and outlet forms (56.40%, 50.60%, 51.90%, respectively), whereas girls had more muscular types (51.80%). Most patients with pulmonary hypertension had perimembranous defects (83.10%). The majority of patients with pulmonary hypertension had large (63.40%) or moderate (36.60%) defects. Pulmonary hypertension had a significant association with defect size ( p < 0.001). After surgery, residual defects were found mostly in cases of large defects (84.60%). Most patients with spontaneous closure were younger than 4 years. Conclusion Almost four-fifths of children with ventricular septal defects had perimembranous types, and almost one-third had pulmonary hypertension which was associated with defect size. Two-fifths of the defects closed spontaneously. There was a low incidence of complications after surgery.

scholarly journals Pattern of Congenital Heart Disease in Children Presenting at Paediatric Cardiology Unit in Chattagram Maa Shishu-O-General Hospital, Chittagong

2018 ◽  
Vol 16 (2) ◽  
pp. 40-43
Author(s):  
Sukhendu Shekhar Sen ◽  
Tanuka Barua ◽  
Dipika Dey ◽  
Mahmood A Chowdhury ◽  
Lutfan Nessa
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Detection ◽  
Congenital Heart ◽  
Septal Defect ◽  
Color Doppler ◽  
Mortality And Morbidity ◽  
Diagnostic Facility ◽  
Disease Pattern ◽  
Acyanotic Congenital Heart Disease

Background: Congenital Heart Disease (CHD) is the most common congenital problem in children. Early detection and proper management of congenital heart disease is very important to reduce mortality and morbidity. The purpose of this study was to find out the disease pattern of CHD among children in present situation in a center outside Dhaka.Methods: This study was conducted over a period from March 2016 to June 2017 prospectively and all patients with CHD was diagnosed by Color Doppler Echocardiography aging from 1st day of life to 12 years were included in the study.Results: Acyanotic CHD was most common among CHD. Atrial Septal Defect (ASD) was the commonest acyanotic congenital heart disease 100 (35.7 %) followed by Ventricular Septal Defect (VSD) 77 (27.5 %). Commonest cyanotic CHD was Tetralogy of Fallot (TOF) 9 (3.2 %). Only 25.36 % CHD were diagnosed during neonatal period whereas 54.64 % were diagnosed during the period of 29 days to completion of 12 months. Most of the patient (63.21%) were male.Conclusion: ASD was the commonest acyanotic CHD whereas TOF was the commonest cyanotic CHD. About 80% cases were diagnosed before 1 year of age. With the advancement of diagnostic facility and neonatal care, early detection of CHD is possible and treatment can be started at an earlier age.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 40-43

scholarly journals Brain natriuretic peptide and atrial septal defect size in children

2020 ◽  
Vol 60 (5) ◽  
pp. 277-82
Author(s):  
Siti Aizah Lawang ◽  
Haryanty Kartini Huntoyungo ◽  
Dasril Daud
Keyword(s):  
Brain Natriuretic Peptide ◽  
Atrial Septal Defect ◽  
Natriuretic Peptide ◽  
Significant Positive Correlation ◽  
Septal Defect ◽  
Defect Size ◽  
Large Defect ◽  
Heart Volume ◽  
Positive Correlation ◽  
Children With Asd

Background Atrial septal defect (ASD) is one of the most common forms of congenital heart disease (CHD). Brain natriuretic peptide (BNP) is a heart marker released into the circulation during pressure overload, heart volume expansion, and increased stress on +the myocardial wall. Objective To assess for a possible association between atrial septal defect size and BNP level in pediatric patients. Methods This cross sectional study on children with ASD was done from March to December 2018 in pediatric outpatients and inpatients at Dr. Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi.  Measurement of ASD defect was conducted using echocardiography and categorized as small defect (<3 mm), medium defect (3-8 mm), and large defect (>8 mm). Brain natriuretic peptide was measured using radioimmunoassay and immunoradiometricassay. Nutritional status was categorized using WHO if the patients aged younger than 5 years and NCHS for patients aged equal or more than 5-year-old. Results Mean BNP levels were 65.5 pg/mL in the small ASD group, 273.2 pg/mL in the moderate ASD group, and in 654.5 pg/mL in the large ASD group, with significant differences among ASD groups. We found a significant positive correlation between BNP levels and ASD diameter (r=0.829; P=0.001), with Y regression equation of: (BNP level) =2.624 + 0.009X (ASD diameter in mm). Conclusion Brain natriuretic peptide levels have significant positive correlation with ASD size. Hence, BNP measurements can be used to predict septal defect size in children with ASD. Acyanotic CHD patients with suspected ASD and high BNP levels may have moderate-to-large ASDs.

scholarly journals Pregnancy outcomes in patients with severe pulmonary hypertension and Eisenmenger syndrome treated with sildenafil monotherapy

2014 ◽  
Vol 7 (1) ◽  
pp. 40-42 ◽  
Author(s):  
Reinalyn S Cartago ◽  
Pichy Ann Alan ◽  
Jubert Benedicto
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Pregnancy Outcomes ◽  
Septal Defect ◽  
Elective Caesarean Section ◽  
Eisenmenger Syndrome ◽  
Maternal Condition ◽  
Local Setting ◽  
Inhaled Prostacyclin ◽  
Pulmonary Arterial

Pregnancy outcomes in patients with pulmonary arterial hypertension have not been documented in our local setting. In our institution, access to therapies like nitric oxide, inhaled prostacyclin and iloprost is limited. We describe two such women given sildenafil monotherapy between April and May 2011. Both had an atrial septal defect complicated by Eisenmenger syndrome. Both survived – one after elective Caesarean section for malpresentation (breech) under general anaesthesia, the other after an assisted vaginal delivery. In addition to oral sildenafil, both received oxygen supplementation. To date, there have been three reported cases of pulmonary arterial hypertension in pregnancy treated with sildenafil in combination with another drug. Our two cases demonstrate that treatment for pulmonary arterial hypertension using sildenafil as monotherapy may allow stabilization of the maternal condition and improve clinical outcomes for both mother and baby. However, pregnancy is still discouraged in women with pulmonary arterial hypertension.

scholarly journals Prevalence of Congenital Heart Disease in Neonate in a Tertiary Level Hospital

2013 ◽  
Vol 2 (2) ◽  
pp. 91-95 ◽  
Author(s):  
Md. Nazrul Islam ◽  
MA Hossain ◽  
MA Khaleque ◽  
MK Das ◽  
MRH Khan ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cleft Lip ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
College Hospital ◽  
Cross Sectional ◽  
Transposition Of Great Arteries ◽  
Mortality And Morbidity

Background: Congenital heart disease (CHD) has already been recognized as one of the important cause of neonatal mortality and morbidity. The reported prevalence of CHD in live newborns tends to vary a lot due to various unrecognizable lesions at birth and lack of technical expertise. Methods: A cross sectional study was carried out in the department of Neonatology at Mymensingh Medical College Hospital (MMCH), Bangladesh from January to December 2010 to find prevalence of CHD in neonates. Results: Out of 6560 admitted neonates, 51 were found to have CHD. The prevalence was 7.8/1000 live births. Mean age was 10.2±9.8 days and weight was 2380.5±590.5gms. Respiratory distress was the commonest symptom (71%) followed by cyanosis (26%) and reluctant to feed (24%). Among the CHD Ventricular septal defect (VSD) was the commonest 15/51 and then Atrial septal defect (ASD) 12/51, Patent ductus arteriosus (PDA) 5/51, Transposition of great arteries ( TGA) 4/51, Complex heart disease 4/51 and Tetralogy of Fallot (TOF) 3/51 cases. Some associated non-cardiac anomalies like Down’s syndrome, polydactyly, syndactyly, cleft lip, cleft palate and cataract were found. Risk factors associated with CHD were diabetes mellitus (10%), hypertension (8%) and maternal infection (4%). Among the drugs, anti-pyretic by 20%, anti-emetic by 18%, anti-epileptic by 4%, vitamin-A and hormone each by 2% of mothers respectively. Conclusion: VSD and ASD were the commonest CHD in this study. Thorough clinical examination and proper investigations immediately after admission is essential, which may help us for proper counseling and early intervention. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 91-95 DOI: http://dx.doi.org/10.3126/njms.v2i2.8942

scholarly journals A case of atrial septal defect presenting with recurrent syncope

2021 ◽  
Vol 16 (2) ◽  
pp. 90-93
Author(s):  
Seng Wee Cheo ◽  
Qin Jian Low
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Atrial Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Adult Population ◽  
Eisenmenger Syndrome ◽  
Progressive Dyspnoea

Atrial septal defect (ASD) is a congenital heart disease often encountered in the adult population, as it is frequently asymptomatic in childhood. In untreated patients with ASD, some may go on to develop complications such as atrial arrythmias, pulmonary hypertension and Eisenmenger syndrome. Pulmonary hypertension is seen in 6 – 35% of this group of untreated patients in adulthood as a result of left-to-right shunting. Symptoms of pulmonary hypertension include progressive dyspnoea, ascites and syncope. Here, we would like to illustrate a case of ASD presenting with recurrent syncopal attack.

scholarly journals Pulmonary Embolism or Eisenmenger Syndrome?

2016 ◽  
Vol 8 ◽  
Author(s):  
Anna L. Fanelli ◽  
Gabriella Agnoletti ◽  
Domenica Garabello ◽  
Mauro Giorgi ◽  
Chiara Calcagnile ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Septal Defect ◽  
Late Complication ◽  
Defect Closure ◽  
Eisenmenger Syndrome ◽  
Suspected Pulmonary Embolism

<p>Eisenmenger syndrome is a late complication of untreated congenital heart disease associated with left to right shunt, that can prompt in situ pulmonary thrombosis.</p><p>Herein the case of a 41 year old man with suspected pulmonary embolism, where an atrial septal defect lead to Eisenmenger Syndrome, is presented. Only lung transplantation and surgical defect closure revealed to be the optimal treatment.</p>

Reversing Inoperability in Eisenmenger Syndrome: The “Drug-and-Banding” Approach

2020 ◽  
Vol 11 (5) ◽  
pp. 646-648
Author(s):  
Nicola Pradegan ◽  
Rita Pesce ◽  
Biagio Castaldi ◽  
Lorenza Zanotto ◽  
Giovanni Stellin ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Septal Defect ◽  
Pulmonary Vascular Resistance ◽  
Congenital Heart ◽  
Septal Defect ◽  
Functional Improvement ◽  
Eisenmenger Syndrome ◽  
Vasodilator Therapy

Eisenmenger syndrome (ES) has been considered a cause of inoperability in patients with congenital heart disease (CHD). Even if long-standing vasodilators are efficient to reduce pulmonary vascular resistance (PVR), the best approach to grant stable repair of these patients is still unknown. We describe the case of a 28-year-old man with a diagnosis of untreated large ventricular septal defect and established ES. After few years of vasodilator therapy, the patient underwent pulmonary banding with significant reduction of his PVR. His CHD was then repaired, with clinical and functional improvement at 2-year follow-up.

CURRENT ASPECTS OF CORONARY HEART DISEASE DIAGNOSIS AND TREATMENT

2020 ◽  
pp. 5-10
Author(s):  
O. M. Korzh
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Drug Therapy ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Myocardial Revascularization ◽  
Disease Diagnosis ◽  
Percutaneous Coronary Angioplasty ◽  
Mortality And Morbidity ◽  
Intravascular Thrombosis

Among the cardiovascular diseases associated with atherosclerosis, chronic coronary heart disease, including angina, is the most common form. It is the myocardium lesion that develops as a result of an imbalance between the coronary circulation and metabolic needs of heart muscle. The presence of angina symptoms often indicates a pronounced narrowing of one or more coronary arteries, but also occurs in non−obstructive arterial impairment and even in normal coronary arteries. Factors of functional damage to the coronary arteries are spasm, temporary platelet aggregation and intravascular thrombosis. Today there are opportunities not only to use the therapy with proven effectiveness, aimed at reducing the risk of complications, including fatal, but also to treat angina (ischemia), which improves the patient's life quality. The drug protocol includes the ones with a proven positive effect on this disease prognosis, which are mandatory if there are no direct contraindications to use, as well as a large group of antianginal or anti−ischemic drugs. The choice of a particular drug or its combinations with other drugs is carried out in accordance with generally accepted recommendations: taking into account the individual approach, the severity of angina, hemodynamic parameters (heart rate and blood pressure, presence of comorbid conditions). If drug therapy is ineffective, the option of coronary myocardial revascularization (percutaneous coronary angioplasty or coronary artery bypass grafting) is considered. Due to the high mortality and morbidity rates of coronary heart disease worldwide, one of the priorities of practical health care is the prevention of diseases caused by atherosclerosis. Key words: coronary heart disease, angina, family physician, prognosis, drug therapy.

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