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The pregnancy outcomes for mother and baby of women with a systemic right ventricle
  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 number of adults and hence women with congenital heart disease is increasing. A group of women for which pregnancy poses potential risks are those with a systemic right ventricle. This studies aims to assess the maternal and fetal outcomes of pregnancy in this group.

Methods We retrospectively studied cases managed through the joint Cardiac Obstetric clinic at Birmingham Women's Hospital over a 6 year period. An assessment of the effect of pregnancy on maternal cardiac function was made by comparison of prenatal, post delivery and latest follow-up changes in right ventricular function and NYHA class. Wilcoxon signed rank test was used to compare outcomes with matched controls.

Results 18 women, with 31 pregnancies were included. There was a significant deterioration in both right ventricular function and NYHA class post delivery between patients and controls (p=0.02 and 0.004). At latest follow-up this was still seen for NYHA class (p=0.01), but not for RV function. 11 Deliveries were preterm with 3 being before 34 weeks gestation, no deliveries were for maternal reason. The caesarean section rate was 39%, performed either for fetal reasons or previous caesarean.

Conclusion This is the only study of women with a systemic right ventricle undertaken in pregnancy that uses controls at a comparison. It shows that a pregnancy can cause a significant permanent deterioration in symptoms and escalate deterioration in right ventricular function. This data will change the pre pregnancy counselling in this cohort and allow it to be truly evidence based.

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