Abstract 15706: Pregnancy Outcome After Preconcpetion Evaluation in Women With Heart Disease
Background: Cardiovascular disease is the leading cause of maternal mortality in pregnancy in western countries. The number of women with preexisting cardiac disease desiring pregnancy is increasing; therefore, preconception evaluation to assess maternal and fetal risks can determine necessary interventions prior to conception to improve outcome.
Objectives: This observational pilot study sought to determine pregnancy outcomes in women with heart disease after preconception evaluation.
Methods: Clinical records of women who had preconception evaluations at Bluhm Cardiovascular Institute between 1996 and 2012 were retrospectively reviewed.
Results: Of the 400 women who had preconception evaluation, 276 had subsequent pregnancies. Maternal diagnoses and clinical outcomes are summarized in Table 1 and Table 2. Preconception procedures were required in 20 patients: atrial septal defect repair (7); arrhythmia ablation (6); valve replacement (3); pacemaker insertion (2) and coronary revascularization (2). Medication changes were recommended in 32% of women. The 276 pregnancies resulted in 178 live births (112 (64%) vaginal, 63 (36%) cesarean), 45 fetal deaths (85% spontaneous abortions or ectopic pregnancies), and 53 unknown outcomes. Congenital heart disease was diagnosed in 4 (2.3%) of the offspring. None of the women developed clinically significant cardiac complications.
Conclusion: We describe pregnancy outcomes in women with varied heart disease diagnoses and disease severity who had preconception evaluation. Preconception evaluation may afford the opportunity to improve clinical outcome for mother and baby in women with preexisting heart disease.
Author Disclosures: M.A. Mendelson: None. L.A. Davis: None. A. Andrei: None.
- © 2015 by American Heart Association, Inc.