title: Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center.
abstract: To analyze the spectrum of cardiovascular diseases occurring during pregnancy and delivery at a tertiary referral center.
  
  
  
  All patients presenting at our institution with pre-existing or first diagnosis of cardiac disease were recruited. Cardiac and obstetric complications and maternal and neonatal outcomes were recorded.
  
  
  
  Fifty-two pregnancies in 49 women, including three pregnancy terminations were analyzed. Cardiac lesions were congenital in 26 (53.1%) and acquired in nine (18.4%); six patients (12.2%) had cardiomyopathies, eight (16.3%) ar-rhythmic conditions. A total of 42 women (85.7%) had a pre-existing cardiac condition and seven (14.3%) presented with first manifestation. Overall 22 cardiac complications occurred: five in pregnancy, eight around parturition, nine during follow-up. They included >1 New York Heart Association functional class deterioration (n=5), congestive heart failure/cardiomyopathy (n=5), valve replacement (n=4), sustained arrhythmia (n=3), cerebral insult, aortic dissection, transplantation (one case each), and death (n=2). Mean gestational age at delivery was 36+6. The cesarean section rate was 77.5%; 31.6% were performed for cardiac indications. Obstetric complications happened in 23 pregnancies (46.9%). There was no perinatal loss; cardiac defects were diagnosed in 9.3% (n=5) of offspring.
  
  
  
  Cardiovascular diseases occurring during pregnancy and parturition comprise a heterogeneous spectrum of conditions. Established scores aid in the identification of high-risk patients; however, in our series 14.3% women had been healthy previously.
authors.affiliation: Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany. Waltraut.Merz@ukb.uni-bonn.de
authors.forename: Waltraut M
authors.initials: WM
authors.lastname: Merz
authors.forename: Mignon-Denise
authors.initials: MD
authors.lastname: Keyver-Paik
authors.forename: Georg
authors.initials: G
authors.lastname: Baumgarten
authors.forename: Thorsten
authors.initials: T
authors.lastname: Lewalter
authors.forename: Ulrich
authors.initials: U
authors.lastname: Gembruch
mesh_terms: D001018:Aortic Diseases / Q000175:diagnosis / Q000453:epidemiology; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D036801:Parturition; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D011256:Pregnancy Outcome / Q000453:epidemiology