Introduction:

Heart disease during pregnancy can lead to a clinical deterioration, and even to the death of the mother or the child. There is lack of data as regards this in the scientific literature.

Material and methods:

A retrospective, observational, and analytical study was conducted on a cohort of pregnant women with heart disease. The study included patients with congenital or acquired heart disease or arrhythmias that required hospital admission or urgent treatment due to onset of symptoms. Patients with mild or moderate valve insufficiency, as well as those with no ultrasound data or information about their delivery, were excluded. Primary and secondary cardiac events, as well as obstetric and neonatal events were recorded.

Results:

The study included 104 patients with an equal number of pregnancies. The evaluation by Cardiology was at 32 weeks on average. The mean ejection fraction was 61%, and 23.1% had enlargement of the right ventricle. More than one-quarter (26.9%) of the patients had some previous cardiovascular treatment.

Congenital heart disease was the most common diagnosis (51.9%), followed by valve disease (25.9%), arrhythmias (15.4%), and left ventricular dysfunction (4.8%). Primary cardiac events were observed in 13.5% of the patients, whilst 14.4% had secondary events. Caesarean section due to a cardiac indication was only performed in 21.2%. Neonatal events were recorded in 36.5%, with obstetric events in 14.4%.

Conclusions:

Despite the high risk and aetiological complexity, pregnant women with heart disease were assessed at a late stage by cardiology. This may explain the high rates of maternal and neonatal events. Groups with experience are required to manage these patients.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )