title: [Management and methods of delivery in women with aortic coarctation--results of 64 pregnancies in 41 women].
abstract: OBJECTIVE
  To evaluate maternal morbidity and mortality of women suffering from coarctation of the aorta as well as the perinatal mortality of babies delivered by women with this anomaly of the aorta. According to our experience we recommend a suitable form of a follow up and suggest an optimal mode of delivery for these patients.
  
  
  METHODS
  Original paper.
  
  
  METHODS
  1st and 2nd Department of Gynecology and Obstetrics of the Masaryk University of Brno--Maternity Hospital, Obilní Trh 11, 602 00 Brno, Czech Republic.
  
  
  METHODS
  Our set consists of 34 pregnant women with coarctation of the aorta. These patients were followed up during the pregnancy in the years 1964-1998 by the Centre for Cardiovascular Diseases in Pregnancy in the Maternity Hospital in Brno. Seven women who were not operated on for the coarctation of the aorta (group A) were pregnant 14 times. Twenty seven women who were operated on for the coarctation (group B) had 50 pregnancies.
  
  
  RESULTS
  There were no maternal deaths in our set. From the 12 delivered babies of women with non operated coarctation of the aorta one child was SGA (small for gestational age). From 42 babies born by women who underwent an radical operation of the coarctation of the aorta previously we had to face one death of a newborn who was SGA as well.
  
  
  CONCLUSIONS
  The radical operation of the aorta should be carried out during the first year of age if possible, between the 9th to 12th month, at best. With women who were not operated on there is a greater risk of rupture of the aneurysm of the aorta and aneurysm of the cerebral arteries in the 2nd and 3rd trimester, during the labor and in the early puerperium. We would advise therefore a through follow up during the whole pregnancy. The high BP should be lowered medicamentally. As to the mode of delivery Caesarean section is preferred. With women who were successfully operated on in their early infancy and whose BP is normal or the systolic BP does not exceed 160 mmHg the Caesarean section is not mandatory but elective. We would mostly advise a spontaneous delivery with shortening of the 2nd stage of the labor by forceps or vacuumextraction--the delivery by Caesarean section in accordance with usual obstetrical practice.
authors.affiliation: I. gynekologicko-porodnická klinika LF MU v Brnĕ.
authors.forename: K
authors.initials: K
authors.lastname: Janků
authors.forename: V
authors.initials: V
authors.lastname: Unzeitig
authors.forename: R
authors.initials: R
authors.lastname: Mikulík
authors.forename: B
authors.initials: B
authors.lastname: Uchytil
authors.forename: P
authors.initials: P
authors.lastname: Janků
authors.forename: N
authors.initials: N
authors.lastname: Volková
mesh_terms: D000293:Adolescent; D000328:Adult; D001017:Aortic Coarctation / Q000601:surgery / Q000628:therapy*; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000628:therapy*; D011256:Pregnancy Outcome