title: [Maternal and perinatal outcome in patients with severe systolic dysfunction].
abstract: OBJECTIVE
  The objective of this study was to evaluate maternal and fetal outcome in patients with severe left ventricle systolic dysfunction followed in a tertiary-care hospital.
  
  
  METHODS
  We retrospectively evaluated 12 pregnant women with severe systolic dysfunction, defined as a ejection fraction<40%. Follow-up data included functional class evaluation, occurrence of cardiac and obstetric events, labor data and neonatal outcome. Cardiac events were defined as new onset of arrhythmias, stroke, pulmonary thrombosis, pulmonary edema, cardiac arrest, and death.
  
  
  RESULTS
  The mean ejection fraction was 28.9+/-6.47%. Four patients were in the NYHA class III, and 8 in class I or II on presentation. Ten patients had deteriorated during pregnancy. The most common cardiac event was pulmonary edema (3 patients). Three of the four patients with class III on presentation had a good evolution during pregnancy, and the other one had preterm delivery due to worsening symptoms. There were 2 vaginal spontaneous deliveries and 10 cesarean sections. Small-for-gestational-age birthweight occurred in 10 pregnancies. There was no maternal or neonatal death.
  
  
  CONCLUSIONS
  Pregnancy in patients with severe left ventricle systolic dysfunction increases the risk of maternal complications and compromises fetal growth. It is important to follow this women in a tertiary-care hospital.
authors.affiliation: Clínica obstétricia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paolo, SP.
authors.forename: Marcelo Graziano
authors.initials: MG
authors.lastname: Custódio
authors.forename: Lucas Yugo Shiguehara
authors.initials: LY
authors.lastname: Yamakami
authors.forename: Maria Rita de Figueiredo Lemos
authors.initials: MR
authors.lastname: Bortolotto
authors.forename: Adriana Lippi
authors.initials: AL
authors.lastname: Waissman
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D001724:Birth Weight; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D007231:Infant, Newborn; D008429:Maternal Welfare; D018743:Perinatal Care; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012189:Retrospective Studies; D014463:Ultrasonography; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging / Q000503:physiopathology*