Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes

AbstractBackgroundAtrial septal aneurysm (ASA) is an uncommon cardiac anomaly that increases maternal morbidity during pregnancy. ASA is related to atrial arrhythmia thromboembolism and it may accompany congenital anomalies such as an atrial septal defect (ASD) or patent foramen ovale (PFO). There are no studies examining pregnancy outcomes in pregnant women with ASA. We aimed to investigate the cardiologic parameters and obstetric outcomes of pregnant women diagnosed with ASA.MethodsThis prospective cohort study analyzed 45 pregnant women diagnosed with ASA, who continued their follow-ups in an obstetric tertiary care center.ResultsA total of 45 pregnant women were recruited; seven pregnancies ended before the 20th gestational week (six spontaneous abortion, one fetal anomaly), 38 women gave birth. In total, there were 32 term births (≥37 weeks), six preterm births (<37 weeks), two extremely preterm births <28 weeks). Among 38 babies delivered, several obstetrical complications such as oligohydramnios, spontaneous preterm labor, intrauterine growth restriction (IUGR), preeclampsia and gestational diabetes mellitus (GDM) developed in 16 patients, while 22 women ended with term pregnancy without any complications. Deep venous thrombosis (DVT) developed in one patient.ConclusionASA may have an increased risk for cardiac complications during pregnancy and may also be associated with poor pregnancy outcomes. Increased attention to these entities with more studies is needed in order to determine a potential risk for pregnant women.

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Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study

10.21203/rs.2.13488/v2 ◽

2019 ◽

Author(s):

Kana Wang ◽

Junguo Xin ◽

Xiaodong Wang ◽

Haiyan Yu ◽

Xinghui Liu

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Fetal Mortality ◽

Cardiac Complications ◽

Care Hospital ◽

Cardiac Events ◽

Substantial Risk ◽

Severe Type

Abstract Background Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied.Methods Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed.Results A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias.Conclusions Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.

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Maternal and Fetal Outcome of Pregnancy with COVID- 19 in A Tertiary Level Hospital, Bangladesh

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v40i1.57058 ◽

2022 ◽

Vol 40 (1) ◽

pp. 10-16

Author(s):

Afroza Akhter ◽

Md Aminul Islam ◽

Shahjad Hossain Md Al Momen ◽

Munshi Sariful Islam ◽

Rehnuma Karim ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Fetal Outcome ◽

Critical Conditions ◽

Military Hospital ◽

Cardiac Anomaly ◽

Cross Sectional ◽

Congenital Cardiac Anomaly ◽

Vaginal Deliveries ◽

Increased Risk

Introduction: Pregnant women have long been recognized as a vulnerable population during infectious disease pandemics due to physiological changes in the immune, pulmonary, cardiac and coagulation systems. It is essential to acquire knowledge of pregnancy outcomes, potential complications and neonatal health conditions born to an infected mother with COVID-19. Material and methods: This cross-sectional observational study was conducted in Combined Military Hospital (CMH), Jashore from June 2020 to July 2021 among 100 hospitalized laboratory-confirmed COVID-19 positive pregnant women, patients who had clinical symptoms of COVID but RT PCR negative were excluded. The aim of the study was to evaluate the clinical profile and maternal and fetal outcome of pregnancy. Relevant data were recorded in a preformed data collection sheet and analyzed by SPSS version 20. Results: Among 100 COVID-19 positive hospitalized pregnant women, the mean age of participants was 27years (range 19-40 years), Maximum infection rate observed during 12 to 28 weeks of gestation among the participants, 21% got infected at 37 to 40 weeks of gestation and 20% got infected at 32 to 36 weeks. Seventy-four percent patients underwent delivery during the study & 23% of them continued with ongoing pregnancy; 67 of the participants underwent LUCS and 7 vaginal deliveries were done, 3% had abortion and IUFD 1% ,61% were multipara and 39% were Primipara, associated co-morbidities were subclinical hypothyroidism(15%), pregnancy induced HTN(12%) and GDM(8%); 36% participants were asymptomatic and 44% had mild symptoms, rate of LUCS was higher than (90.64%) vaginal delivery. Among the 73 live births, 80.82% were term and 10.18% were preterm of neonates, small for gestational was seen in the case of 20.55% neonates. Testing for SARS-CoV-2 was performed in all neonatal throat swabs and found positive in one case only. Eighty-six percent neonates were well-baby and 9.58% neonates required NICU admission. There were 2 neonatal deaths due to severe prematurity and 2 babies were found to have congenital cardiac anomaly and cleft lip, cleft palate. Though 36% of patients were asymptomatic but 10% were severe and in the critical stage. HDU support needed for 8% of patients and ICU support for 6%. Conclusion: This cross-sectional study supports that pregnant women with COVID-19 infection are at increased risk of adverse pregnancy and birth outcomes and a low risk of congenital transmission. Availability of ICU in critical conditions is needed for better pregnancy outcomes. J Bangladesh Coll Phys Surg 2022; 40: 10-16

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Pregnancy outcomes among 31 patients with tetralogy of Fallot

10.21203/rs.2.13488/v5 ◽

2019 ◽

Author(s):

Kana Wang ◽

Junguo Xin ◽

Xiaodong Wang ◽

Haiyan Yu ◽

Xinghui Liu

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Fetal Mortality ◽

Cardiac Complications ◽

Care Hospital ◽

Cardiac Events ◽

Substantial Risk ◽

Severe Type

Abstract Background Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied. Methods Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed. Results A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias. Conclusions Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.

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Pregnancy outcomes among women with thyrotoxicosis a retrospective cohort study

10.21203/rs.3.rs-162247/v1 ◽

2021 ◽

Author(s):

Panwad Harn-a-morn ◽

Prapai Dejkhamron ◽

Theera Tongsong ◽

Suchaya Luewan

Keyword(s):

Preterm Birth ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Adverse Outcomes ◽

Low Risk ◽

Obstetric Outcomes ◽

Study Group ◽

Increased Risk ◽

Adverse Pregnancy ◽

Singleton Pregnancies

Abstract Objective: To compare adverse outcomes between: 1) pregnant women with thyrotoxicosis and low risk pregnancies, 2) pregnant women with thyrotoxicosis requiring no anti-thyroid drug (ATD) and low risk pregnancies, and 3) those treated with methimazole (MMI) and propylthiouracil (PTU)Methods: The medical records of singleton pregnancies with thyrotoxicosis were comprehensively reviewed. Low-risk pregnancies matched for age and parity were randomly recruited as controls. The obstetric outcomes were compared between both groups, and the outcomes of various subgroups of the study group were also compared.Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls, the women of the study group had significantly higher rates of low birth weight (LBW) (23.7% vs 17.7%; p:0.036), preterm birth (19.3% vs 12.3%; p:0.007), preeclampsia (8.5% vs 4.4%; p: 0.019) and cesarean section (21.5% vs 16.0%; p:0.046). In the study group (thyrotoxicosis), 67, 127, and 158 patients were treated with MMI, PTU and no anti-thyroid drug (ATD), respectively. All obstetric outcomes were comparable between the women treated with PTU and those with MMI, and between the controlled and uncontrolled groups. However, women who needed ATD had significantly higher rates of LBW and preterm birth than those without medications.Conclusions: Thyrotoxicosis, whether treated or not needing ATDs, was significantly associated with an increased risk of adverse pregnancy outcomes. Also, active disease, indicated by the need for ATD significantly increased the risk of such adverse outcomes, whereas the patients treated with MMI or PTU had comparable adverse outcomes.

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Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study

10.21203/rs.2.13488/v4 ◽

2019 ◽

Author(s):

Kana Wang ◽

Junguo Xin ◽

Xiaodong Wang ◽

Haiyan Yu ◽

Xinghui Liu

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Fetal Mortality ◽

Cardiac Complications ◽

Care Hospital ◽

Cardiac Events ◽

Substantial Risk ◽

Severe Type

Abstract Background Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied. Methods Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed. Results A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias. Conclusions Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.

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Pregnancy outcomes among 31 patients with tetralogy of Fallot

10.21203/rs.2.13488/v3 ◽

2019 ◽

Author(s):

Kana Wang ◽

Junguo Xin ◽

Xiaodong Wang ◽

Haiyan Yu ◽

Xinghui Liu

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Fetal Mortality ◽

Cardiac Complications ◽

Care Hospital ◽

Cardiac Events ◽

Substantial Risk ◽

Severe Type

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Pregnancy Outcomes among Women with Graves’ Hyperthyroidism: A Retrospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10194495 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4495

Author(s):

Panwad Harn-a-morn ◽

Prapai Dejkhamron ◽

Theera Tongsong ◽

Suchaya Luewan

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Adverse Outcomes ◽

Low Risk ◽

Obstetric Outcomes ◽

Increased Risk ◽

Adverse Pregnancy

Objective: The primary objectives of this study are to compare the rates of preterm birth; fetal growth restriction and low birth weight between the following groups: (1) pregnant women treated for thyrotoxicosis and low-risk pregnancies; (2) between pregnant women with thyrotoxicosis with no need of medication and low-risk pregnancies; and (3) between those treated with MMI and PTU. Methods: The medical records of singleton pregnancies with thyrotoxicosis were comprehensively reviewed. Low-risk pregnancies matched for age and parity were randomly recruited as controls. The obstetric outcomes were compared between both groups; the outcomes of various subgroups of the thyrotoxicosis group were also compared. Results: A total of 408 pregnant women with thyrotoxicosis were recruited. Compared with the controls; the women of the thyrotoxicosis group had significantly higher rates of low birth weight (LBW) (23.7% vs. 17.7%; p: 0.036), preterm birth (19.3% vs. 12.3%; p: 0.007), preeclampsia (8.5% vs. 4.4%; p: 0.019) and cesarean section (21.5% vs. 16.0%; p: 0.046). In the thyrotoxicosis group; 67; 127; and 158 patients were treated with MMI; PTU and no anti-thyroid drug (ATD), respectively. All obstetric outcomes were comparable between the women treated with PTU and those with MMI; and between the controlled and uncontrolled groups. However, women who needed ATD had significantly higher rates of LBW and preterm birth than those without medications. Conclusions: Thyrotoxicosis, whether treated or not needing ATDs, was significantly associated with an increased risk of adverse pregnancy outcomes. Also, active disease, indicated by the need for ATD significantly increased the risk of such adverse outcomes; whereas the patients treated with MMI or PTU had comparable adverse outcomes.

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Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study

Viruses ◽

10.3390/v13050853 ◽

2021 ◽

Vol 13 (5) ◽

pp. 853

Author(s):

Sara Cruz Melguizo ◽

María Luisa de la Cruz Conty ◽

Paola Carmona Payán ◽

Alejandra Abascal-Saiz ◽

Pilar Pintando Recarte ◽

...

Keyword(s):

Pregnant Women ◽

Perinatal Outcomes ◽

Preterm Births ◽

Hypertensive Disorder ◽

Obstetric Emergency ◽

Increased Risk ◽

Emergency Group ◽

Adverse Perinatal Outcomes ◽

Maternal Disease ◽

The Relationship

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

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Role of antenatal plasma cytomegalovirus DNA levels on pregnancy outcome and HIV-1 vertical transmission among mothers in the University of Zimbabwe birth cohort study (UZBCS)

Virology Journal ◽

10.1186/s12985-021-01494-3 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Kerina Duri ◽

◽

Simbarashe Chimhuya ◽

Exnevia Gomo ◽

Privilege Tendai Munjoma ◽

...

Keyword(s):

Pregnant Women ◽

Vertical Transmission ◽

Pregnancy Outcomes ◽

Preterm Births ◽

Multivariate Logistic Regression Model ◽

Birth Cohort Study ◽

Childhood Disability ◽

Hiv 1 ◽

Cmv Dnaemia ◽

Rna Levels

Introduction Despite being a leading infectious cause of childhood disability globally, testing for cytomegalovirus (CMV) infections in pregnancy is generally not done in Sub-Sahara Africa (SSA), where breastfeeding practice is almost universal. Whilst CMV and human immunodeficiency virus (HIV) are both endemic in SSA, the relationship between antenatal plasma CMV-DNA, HIV-1-RNA levels and HIV-1-mother to child transmission (MTCT) including pregnancy outcomes remains poorly described. Methods Pregnant women at least 20 weeks’ gestational age at enrolment were recruited from relatively poor high-density suburbs in Harare, Zimbabwe. Mother-infant dyads were followed up until 6 months postpartum. In a case–control study design, we tested antenatal plasma CMV-DNA levels in all 11 HIV-1 transmitting mothers, as well as randomly selected HIV-infected but non-transmitting mothers and HIV-uninfected controls. CMV-DNA was detected and quantified using polymerase chain reaction (PCR) technique. Antenatal plasma HIV-1-RNA load was quantified by reverse transcriptase PCR. Infants’ HIV-1 infection was detected using qualitative proviral DNA-PCR. Predictive value of antenatal plasma CMV-DNAemia (CMV-DNA of > 50 copies/mL) for HIV-1-MTCT was analyzed in univariate and multivariate regression analyses. Associations of CMV-DNAemia with HIV-1-RNA levels and pregnancy outcomes were also explored. Results CMV-DNAemia data were available for 11 HIV-1 transmitting mothers, 120 HIV-infected but non-transmitting controls and 46 HIV-uninfected mothers. In a multivariate logistic regression model, we found a significant association between CMV-DNAemia of > 50 copies/mL and HIV-1 vertical transmission (p = 0.035). There was no difference in frequencies of detectable CMV-DNAemia between HIV-infected and -uninfected pregnant women (p = 0.841). However, CMV-DNA levels were higher in immunosuppressed HIV-infected pregnant women, CD4 < 200 cells/µL (p = 0.018). Non-significant associations of more preterm births (< 37 weeks, p = 0.063), and generally lower birth weights (< 2500 g, p = 0.450) were observed in infants born of HIV-infected mothers with CMV-DNAemia. Furthermore, in a multivariate analysis of HIV-infected but non-transmitting mothers, CMV-DNAemia of > 50 copies/mL correlated significantly with antenatal plasma HIV-1-RNA load (p = 0.002). Conclusion Antenatal plasma CMV-DNA of > 50 copies/mL may be an independent risk factor for HIV-1-MTCT and higher plasma HIV-1-RNA load, raising the possibility that controlling antenatal CMV-DNAemia might improve infant health outcomes. Further studies with larger sample sizes are warranted to confirm our findings.

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The presence of lupus nephritis additionally increases the risk of preeclampsia among pregnant women with systemic lupus erythematosus

Lupus ◽

10.1177/09612033211004716 ◽

2021 ◽

pp. 096120332110047

Author(s):

Katarina Bremme ◽

Sonja Honkanen ◽

Iva Gunnarsson ◽

Roza Chaireti

Keyword(s):

Caesarean Section ◽

Lupus Nephritis ◽

Pregnant Women ◽

Lupus Erythematosus ◽

Premature Birth ◽

Renal Involvement ◽

Significant Risk ◽

Obstetric Outcomes ◽

Increased Risk ◽

Renal Lupus

Introduction Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. Aims: The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN). Patients and methods The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section. Results Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035). Conclusions Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.

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