[Pregnancy and congenital heart disease].
OBJECTIVE
Since the creation of the Adult Congenital Heart Disease Units and of the High Obstetric Risk Units, there has been increasing interest in hemodynamic and obstetric outcomes in pregnant woman with congenital heart disease.


METHODS
Retrospective descriptive study of 56 women with congenital heart disease aged (mean [range]) 25 (18-40) years, who experienced a total of 84 pregnancies between January 1992 and August 2006. The women were divided into three pregnancy risk groups: A, low-risk; B, moderate-risk, and C, high-risk.


RESULTS
The incidence of complications during pregnancy was 1.6%, 15%, and 20% in groups A, B, and C, respectively; the incidence during the puerperium was 2%, 23%, and 50%, respectively; and maternal mortality was 0%, 7.6%, and 25%, respectively. Overall, 69 children were born, and the prematurity rates in the three groups were 11%, 15%, and 100%, respectively. The following risk factors were studied: pulmonary hypertension, cyanosis, arrhythmia, left ventricular outflow tract obstruction, right ventricular dilatation, systemic right ventricle, and anticoagulation therapy. The risk factor most significantly associated with maternal or fetal morbidity or mortality was found to be pulmonary hypertension.


CONCLUSIONS
Risk stratification in pregnant women with congenital heart disease provides prognostic information that can help multidisciplinary teams to target care to achieve the best results.
Manso
Begoña
B
Unidad de Cardiopatías Congénitas del Adolescente y del Adulto, Unidad de Embarazo de Alto Riesgo Obstétrico, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.
Gran
Ferrán
F
Pijuán
Antonia
A
Giralt
Gemma
G
Ferrer
Queralt
Q
Betrián
Pedro
P
Albert
Dimpna
D
Rosés
Ferrán
F
Rivas
Nuria
N
Parra
Montserrat
M
Girona
Josep
J
Farrán
Inmaculada
I
Casaldáliga
Jaume
J
D000293:Adolescent; D000328:Adult; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000151:congenital* / Q000453:epidemiology*; D006801:Humans; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors