Abstract 16474: Pregnancy Outcomes in Patients With Congenital Heart Disease: The POPS Study
Objectives: Maternal and fetal pregnancy outcomes were investigated at a single tertiary center. We investigated incidence of spontaneous abortions, elective terminations, and maternal and fetal complications in these pregnancies.
Methods: Pregnancy outcomes in 102 clinic patients with history of congenital heart disease were investigated through retrospective analysis using surveys and chart review between the period of January 1980 and May 2011. The demographic distribution included 58.5% Caucasian, 10.8% Hispanic, 10.8% African-American, 3.0% Asian and 16.6% of unknown/other race.
Results: The study investigated 177 pregnancies in 102 women, with a median age at pregnancy of 25 ± 5.9 years. The pregnancies resulted in 30 spontaneous abortions (16.9%) and 13 elective terminations (7.3%). The incidence of spontaneous abortions was highest amongst women with tetralogy of Fallot (ToF) (complete surgical correction: 33.3%, palliative correction: 100%); pulmonary stenosis (31.5%), systemic right ventricles (26%), ASD/VSD (23.8%), aortic stenosis (19.8%), coartation of Aorta (10.8%). One palliated ToF patient had four spontaneous abortions. There were no maternal deaths during the peripartum period, and no intrauternine fetal demise. Maternal complications included worsening in New York Heart Association Class (4.4%), pulmonary edema (2.2%), need for emergent cardiac surgery (1.1%), sustained arrhythmias (1.1%). Mean neonatal birth weight was 3056.3 g ± 673.1 g, and mean gestational age was 37.3 ± 3.1 weeks. Neonatal complications included prematurity (8.7%), respiratory distress syndrome (2.8%), and intrauterine growth retardation (0.7%).
Conclusion: Pregnancy in adults with CHD can be undertaken safely without increased maternal or fetal mortality and with limited maternal and neonatal morbidity. Anticipatory guidance for increased rates of spontaneous abortions and elective terminations compared to national averages should be provided.
- © 2011 by American Heart Association, Inc.