| Eisenmenger's syndrome and pregnancy. | |
| | |
MedLine Citation:
|
PMID: 503376 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Two additional cases of successfully managed Eisenmenger's syndrome (ES) during pregnancy are described. A review of the literature on this subject revealed 115 reported cases, of which only 44 (including our two cases) were felt to be adequately documented, representing 70 pregnancies. These formed the material for statistical evaluation. Fifty-two per cent of all patients died in connection with pregnancy. Thirty and three-tenths per cent of all pregnancies results in maternal death. Maternal mortality in first, second, and third pregnancies was not significantly different. A high incidence of maternal death was assoicated with hypovolemia, thromboembolic phenomena and preeclampsia, but mortality was not higher in the toxemia than in the non-toxemia group. Cesarean sections and other operations are associated with extremely high maternal mortality during pregnancy. Thirty-four per cent of all vaginal deliveries, three out of four cesarean sections, and only 1 out of 14 pregnancy interruptions (the only one by hysterotomy) resulted in maternal death. Abortions are significantly safer than any kind of delivery (p less than 0.05). Ventricular septal defect (VSD) is the most frequent underlying shunt defect. Maternal mortality in association with VSD is higher (60%) than in association with atrial septal defect (ASD) (44%) and patent ductus arteriosus (PDA) (41.7%). The majority of maternal deaths occurred during or within the first week after delivery. Only 25.6 per cent of all pregnancies reached term. At least 54.9 per cent of all deliveries occurred prematurely. Thirty and two-tenths per cent of all infants showed intrauterine growth retardation. This represented almost half of all new borns with available information. Perinatal mortality reached 28.3 per cent and was significantly associated with prematurity (p less than 0.001). Pregnancy is contraindicated in patients with ES. Abortion is the treatment of choice, once pregnancy has occurred. Where interruption of pregnancy is refused, utmost care must be taken to assure maternal and fetal survival. A protocol for the management of such pregnancies is discussed on the basis of available information. |
| | |
Authors:
|
N Gleicher; J Midwall; D Hochberger; H Jaffin |
Related Documents
:
|
15145366 - Maternal mortality--a review of current trends. 8178896 - The morbidity and mortality of pregnancy: still risky business. 9292636 - Underreporting and misclassification of maternal mortality in taiwan. 5762626 - Leptospirosis in human pregnancy followed by death of the foetus. 7018166 - Stimulation of labor in cases of premature rupture of the membranes at or near term. a ... 1419996 - A prospective study comparing the outcome of oocytes retrieved in the aspirate with tho... |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Obstetrical & gynecological survey Volume: 34 ISSN: 0029-7828 ISO Abbreviation: Obstet Gynecol Surv Publication Date: 1979 Oct |
Date Detail:
|
Created Date: 1980-01-19 Completed Date: 1980-01-19 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0401007 Medline TA: Obstet Gynecol Surv Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 721-41 Citation Subset: IM |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abortion, Therapeutic Adult Eisenmenger Complex* / diagnosis, therapy Female Fetal Growth Retardation / etiology Humans Labor, Obstetric Pregnancy Pregnancy Complications* / diagnosis, therapy Prognosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Considerations on myocardial scintigraphy with 201thallium after stress
Next Document: The streak gonad syndrome.