Complications of Pregnancy in Women with Congenital Heart Diseases: A review study
Complications of Pregnancy in Women with Congenital Heart Diseases: A review study
Mobina Hosein Fakhrabadi,1,*Iman Masoumi,2Rounak Shahoyi,3
1. Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran. 2. Student Research Committee, North Khorasan University of Medical Sciences, Bojnourd, Iran 3. Department of Midwifery, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Introduction: The number of women with congenital heart disease (CHD) at risk of pregnancy is growing because over 90% of them are grown-up into adulthood due to progress in cardiologic and surgical interventions. Pregnant women with congenital heart disease are at increased risk for cardiac and neonatal complications. Various studies have mentioned the complications of pregnancy and childbirth in women with congenital heart disease. Therefore, the present study was conducted with the aim of reviewing the outcomes of pregnancy in women with congenital heart diseases.
Methods: In this study, Persian and English scientific articles published in Google Scholar, MEDLINE, Science Direct, PubMed and SID, using keywords Pregnancy, Delivery and Congenital heart disease were examined without time limit and finally according to the inclusion and exclusion criteria, 14 articles were selected and reviewed.
Results: The results of various studies showed that most frequent maternal complications during pregnancy and delivery are heart failure, arrhythmias, bleeding or thrombosis, and rarely maternal death. Complications of fetus are prematurity, low birth weight, abortion, and stillbirth. Risk stratification of pregnancy and delivery relates to functional status of the patient and is lesion specific. Medication during pregnancy and post-delivery (breast feeding) is a big concern. Especially prescribing medication with teratogenicity should be avoided. Adequate care during pregnancy, delivery, and the postpartum period requires a multidisciplinary team approach with cardiologists, obstetricians, anesthesiologists, neonatologists, nurses and other related disciplines. Caring for a baby is an important issue due to temporarily pregnancy-induced cardiac dysfunction, and therefore family support is mandatory especially during peripartum and after delivery.
Conclusion: Timely pre-pregnancy counseling should be offered to all women with CHD to prevent avoidable pregnancy-related risks. Successful pregnancy is feasible for most women with CHD at relatively low risk when appropriate counseling and optimal care are provided. Maternal cardiac and neonatal complication rates are considerable in pregnant women with congenital heart disease. Patients with impaired sub pulmonary ventricular systolic function and/or severe pulmonary regurgitation are at increased risk for adverse cardiac outcomes.