2012, Number 4
Maternal and perinatal prognosis in pregnant women with congenital heart disease with shunt circuit at Instituto Nacional de Perinatología Isidro Espinosa de los Reyes
Hernández-Pacheco JA, Estrada-Altamirano A, Nares-Torices MÁ, Mendoza-Calderón SA, Orozco-Méndez H, Hernández-Muñoz VA, Lugo-Ayala SA
Language: Spanish
References: 15
Page: 137-146
PDF size: 197.30 Kb.
ABSTRACT
Introduction: Pregnancy and childbirth condition important cardiovascular changes that put women with heart disease in low cardiac reserve. Objective: To determine the incidence of maternal and perinatal complications associated with congenital heart disease present with shunt circuit (CCC) and pregnancy. Material and methods: An observational, descriptive, longitudinal retrolective, performed the statistical database of the National Institute of Perinatology (INPer) between the period January 2005 to January 2010. Results: We performed a comparative cohort study. The first group consisted of 40 pregnant women with congenital heart disease with short circuit (CCC), the second group was composed of 95 women without heart disease. The average maternal age was 25 ± 6.3 years; ventricular septal defect (CIV) was the most frequent CCC (35%) n = 14, an atrial septal defect (CIA) 32.5% n = 13, present the biggest flaws with an average of 20.6 ± 10.4 mm, which favors a higher proportion found in mean pulmonary arterial hypertension (HAP) severe: 35% (n = 14) (MAP) ≥ 41 mmHg, and 6 women had arrhythmias (15.5%). Functional class according to the New York Heart Association (NYHA) class was more frequent I-II. Acute pulmonary edema and dilated cardiomyopathy was present in one case (2.5%), and there were 2 maternal deaths (5%). The most common way of delivery was cesarean (62.2%) n = 24, the pregnancy-associated hypertensive disease was observed in 15% (n = 6). 22.2% (n = 9) and developing preterm infants small for gestational age in 33.3% (n = 13). Conclusions: The (CCC) INPer are frequent, the most common is the (CIV), with large septal defects and high incidence of moderate to severe pulmonary hypertension, hypertensive disease, preterm births and newborns small for gestational age (SGA).REFERENCES