Document Detail


Cardiac complications relating to pregnancy and recurrence of disease in the offspring of women with atrioventricular septal defects.
MedLine Citation:
PMID:  16107486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: In most pregnancy reports, atrioventricular septal defects (AVSD) are not differentiated from more simple septal defects, thus underestimating the risks of pregnancy. To investigate the magnitude and determinants of risk during pregnancy in female patients with balanced AVSD. METHODS AND RESULTS: Using a nation-wide registry (CONCOR), 79 female patients with balanced/isolated AVSD were identified. A total of 29 patients had 62 pregnancies, including 12 miscarriages (19%) and two elective abortions. Detailed recordings of each completed (>20 weeks gestation) pregnancy (n=48, 26 women) were obtained. Cardiovascular events complicated almost 40% of the completed pregnancies. In particular, post-partum persistence of pregnancy-related New York Heart Association (NYHA) class deterioration [23% mainly patients with residual atrial septal defects (ASD)] and deterioration of pre-existing left AV-valvular regurgitation (17%) were frequently recorded. Additional cardiac complications were arrhythmias (19%) and symptomatic heart failure (2%). Congenital heart disease (CHD) recurred in six children (12%): AVSD (n=4, three with left-sided hypoplasia), patent ductus arteriosus (n=1), and ASD (n=1). Three children died including two children with left-sided hypoplasia. CONCLUSION: Pregnancy is not always well tolerated in women with AVSD, predominantly due to NYHA class deterioration and worsening of pre-existing AV-valvular regurgitation. Offspring mortality is high (6.3%), primarily due to recurrence of complex CHD.
Authors:
Willem Drenthen; Petronella G Pieper; Karin van der Tuuk; Jolien W Roos-Hesselink; Adriaan A Voors; Bianca Mostert; Barbara J M Mulder; Philip Moons; Tjark Ebels; Dirk J van Veldhuisen;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-08-17
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-15     Completed Date:  2006-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2581-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Medical Centre Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. w.drenthen@thorax.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Coronary Disease / etiology*
Female
Heart Septal Defects*
Humans
Hypertension, Pregnancy-Induced / etiology
Infant, Newborn
Infertility, Female / etiology*
Pedigree
Pre-Eclampsia / etiology
Pregnancy
Pregnancy Complications, Cardiovascular*
Pregnancy Outcome*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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