Pregnancy and cardiac diseases – diagnosis, management and materno-fetal outcomes: our experience

Introduction: Although with increasing incidence, preexistent or newly induced cardiovascular diseases are still underdiagnosed in pregnancy. A prompt and thorough interdisciplinary reference to cardiologist often improves the maternal and/or fetal outcome.

Methods: A local prospective registry on cardiovascular diseases in pregnancy. 151 female patients (127 pregnant, 24 recent delivery) with known or suspected cardiac disease were referred to our cardiologist. Medical and obstetrical history, treatment, clinical exam, ECG and ecocardiography parameters were obtained; on follow up after delivery (120 patients), premature birth, fetal weight, Apgar score and deaths were recorded.

Results: Mean age was 31.8 ± 5.8 years and 6.6% had twin pregnancies. Mean blood pressure was 130.3 ± 18/83.2 ± 12, mean heart rate 89.5 ± 12 and mean LV ejection fraction 61.4 ± 4. There were 13 cases (8.6%) of congenital heart diseases and 17 (11.3%) of valvular heart diseases (1 case of severe pulmonary stenosis) all with good outcomes. Other significant medical con-ditions recorded were hereditary thrombophilia (16), gestational diabetes (8), hypothyroidism (6), systemic lupus erithematosus (3). There were 81 cases (53.6%) of hypertension with 66 pregnancy-induced; 36 (23.8%) of preeclampsia. Hypertensive group had a mean blood pressure of 140.98 ± 15 /90 ± 10 mmHg and significant worse outcomes: 3 (vs.0) fetal deaths, 36 (vs. 6) premature births, mean Apgar score of 7.8 (vs. 8.8) and lower mean fetal weight: 3127.1 ± 420 ( vs. 2594.5 ± 1000) g, all P< 0.000. 81.5% of hypertensive women were treated with at least one antihypertensive agent (alfa methyl dopa, calcium blockers or beta-blockers and ACE inhi-bitors or angiotensin receptor blockers after delivery). Only 21 had prevention with Aspirin.

Conclusions: In pregnant women hypertensive disease is the most frequent and with worse outcome cardio-vascular condition, yet treatable or even preventable with a right management including better risk scree-ning protocols, cardiological evaluation and Aspirin prophylaxis.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
This work is licensed under a Creative Commons Attribution 4.0 International License.