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Pregnancy in women with high risk cardiac disease – experience from a single UK centre
  1. T Selman1,
  2. S Bowater2,
  3. S Thorne2,
  4. P Thompson1
  1. 1Birmingham Women's Hospital NHS Foundation Trust, Birmingham, UK
  2. 2University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

Abstract

Introduction The survival of children born with congenital heart disease has rapidly increased and hence more such women are seen in our antenatal clinics. Birmingham Women's Hospital and Queen Elizabeth Hospital have attempted to address this problem by providing a joint Cardiac Obstetric clinic. This study reviews the outcomes of women attending our clinic.

Methods The data base of women seen in the joint clinic over a 7 year period was retrospectively reviewed for the outcomes of women with high risk cardiac disease, WHO class 3 or 4.

Results There was information on 93 women with 125 high risk pregnancies continuing beyond the 1st trimester. Three pregnancies ended in spontaneous mid trimester loss. 22 deliveries were before 37 weeks with 12 being before 34 weeks. Of those prior to 34 weeks 3 were delivered for maternal cardiac disease. 13 deliveries in total were performed by caesarean section for maternal reasons. Five babies beyond viability died in the neonatal period. There were 11 significant maternal complications either antenatally or in the puerperium and there was 1 late maternal death at 6 months.

Conclusion With joint care this study shows that high risk pregnant women with cardiac disease can have successful pregnancies (93.6% of pregnancies), with a low maternal mortality. In order to achieve such good outcomes these patients require management a dedicated multidisciplinary team such as ours. We are currently prospectively investigating the late effects of pregnancy in this group to help improve our pre-pregnancy counselling.

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