A Clinical Study of Maternal Heart Disease in Pregnancy / 대한주산의학회잡지

OBJECTIVE:To assess the pregnancy outcomes complicated by maternal heart diseases. METHODS:From 1995 to 2006, medical records of pregnant women who had received full antenatal care at Kangnam St. Marys Hospital and Our Lady of Mercy Hospital with maternal heart diseases were reviewed. RESULTS:Forty one deliveries from 39 women were enrolled for analysis. 11 (26.7%) cases of the heart diseases were of rheumatic origin, 22 (53.7%) cases had arrhythmic disease, 3 (7.3%) cases had congenital heart disease, and the remaining 5 (12.3%) cases were consisted of miscellaneous diseases such as ischemic heart disease and congestive heart failure. There were 4 (9.8%) cases of pulmonary edema which had occurred as maternal complication during pregnancy. One case was a twin pregnancy. All of them were in New York Heart Association (NYHA) functional classes I, II before, during, and after delivery. Mean gestational age at birth and birth weight were 38.6 weeks and 3,157 g respectively. Neonatal congenital heart disease was shown in only one case with tetralogy of Falot and the other fetal anomaly was multicystic dysplastic kidney. CONCLUSION:Our results indicate that successful pregnancy outcome in patients with maternal heart disease would be possible in NYHA functional classes of I and II without any increased risk of complications.

Pregnancies Complicated by Maternal Heart Diseases / 대한산부인과학회잡지

OBJECTIVE: To assess the pregnancy outcomes complicated by maternal heart diseases. METHODS: From 1994 to 2001, medical records of pregnant women who had reached at least 20 weeks of gestation with maternal heart diseases were reviewed. RESULTS: 224 deliveries of 195 women were enrolled in this study. In 117 (52.2%) cases the heart diseases were of rheumatic origin, in 96 (42.9%) cases congenital, and the remaining 11 (4.9%) cases were miscellaneous group that included arrhythmia, cardiomyopathy, and mitral valve prolapse. There were 2 (0.9%) cases of maternal death related to pregnancy. Majority (91.9%) were in New York Heart Association functional classes I, II before, during, and after delivery. Mean gestational age at birth and birth weight were 37.9 weeks and 2883 gm. Perinatal mortality rate was 17.9/1000 and the rate of congenital malformation was 2.7%. Recurrence risk of neonatal congenital heart disease was 2.1%. CONCLUSION: Most complications were developed in the pregnancies complicated by maternal heart diseases with New York Heart Association functional classes III, IV. Functional status of the pregnant women is the important risk factor in maternal and fetal outcomes.