Neonatal and maternal outcomes of pregnancy with maternal cardiac disease (the NORMANDY study) : Years 2000-2014.
Pregnancies complicated by congenital or acquired heart diseases are at high risk of maternal, obstetrical and neonatal poor outcomes. During the period 2000-2014, 197 pregnancies occurring in 147 women with heart disease were managed in our institution. A maternal cardiac event complicated 13 pregnancies. Obstetrical and neonatal complications occurred respectively in 35.0% (95% CI [28.3-41.7]) and 37.0% (95% CI [30.3-43.7]) of pregnancies. All complications were more frequent amongst cardiomyopathies or obstructive and conotruncal lesions, whereas left-to-right shunts were less prone to present with complications. Complications occurred between the end of the second trimester and the middle of the third trimester or during the post-partum period. Caesarean section was the mode of delivery in 37% (95% CI [30.3-43.7]) of cases, and general anaesthesia was performed in 8.6% of cases (95% CI [4.7-12.5]). Although reporting relatively mild heart diseases, this retrospective study shows an evolution in the management of pregnancies complicated by cardiopathies. Vaginal delivery under locoregional anaesthesia can be achieved in many pregnancies, whereas others require strict multi-disciplinary follow-up in a specialized centre. The creation of a large, multi-centric registry might help improve and personalize the management of these high-risk pregnancies.
Department of Anaesthesiology and Critical Care, University Hospital of Caen, 14000 Caen, France. Electronic address: bonnet-v@chu-caen.fr.
Vincent
V
Bonnet
Department of Anaesthesiology and Critical Care, University Hospital of Caen, 14000 Caen, France.
Thérèse
T
Simonet
Department of Cardiology, University Hospital of Caen, avenue de la Côte-de-Nacre, 14000 Caen, France.
Fabien
F
Labombarda
Department of Gynaecology-Obstetrics and Reproductive medicine, University Hospital of Caen, avenue de la Côte-de-Nacre, 14000 Caen, France.
Patricia
P
Dolley
Department of Cardiology, University Hospital of Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; University of Caen Basse-Normandie, 14000 Caen, France.
Paul
P
Milliez
Department of Gynaecology-Obstetrics and Reproductive medicine, University Hospital of Caen, avenue de la Côte-de-Nacre, 14000 Caen, France; University of Caen Basse-Normandie, 14000 Caen, France.
Michel
M
Dreyfus
Department of Anaesthesiology and Critical Care, University Hospital of Caen, 14000 Caen, France; University of Caen Basse-Normandie, 14000 Caen, France.
Jean-Luc
JL
Hanouz
D000328:Adult; D009202:Cardiomyopathies / Q000150:complications / Q000453:epidemiology; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000453:epidemiology; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D005602:France / Q000453:epidemiology; D006331:Heart Diseases / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
Cardiopathy; Outcome; Pregnancy