[Preterm labor and IUGR rates in patients with cardiac anomalies in the material of the Pregnancy Pathology Unit at the Jagiellonian University OB/GYN Department between 1986-1999]. / Czestosc porodów przedwczesnych i hipotrofii w grupie pacjentek z wadami serca w materiale Oddzialu Patologii Ciazy Katedry Ginekologii i Poloznictwa Collegium Medicum Uniwersytetu Jagiellonskiego w latach 1986-1999.

INTRODUCTION: Advance in medicine in general caused more and more women with cardiac defects reach reproductive age. AIM: Analysis of kind and advance of cardiac disease influence on preterm labour and IUGR rates. MATERIAL AND METHODS: A prospective study on 232 pregnant patients with cardiac malformations, who were hospitalised in Pathology of Pregnancy Unit of OB./ GYN Jagiellonian University Clinic was performed between 1986-1999. Acquired data were compared with results obtained from control group of 424 pregnant patients with physiological course of pregnancy. RESULTS: Results prove of shorter pregnancy duration in patients with higher NYHA classes. Preterm labour rate in patients of NYHA III and IV equals to 31.15% and is 3 times higher than in control group. Patients of NYHA I and II revealed comparable gestational age with control group. CONCLUSIONS: Worse obstetric outcome is characteristic for 3rd and 4th NYHA classes. Intrauterine growth retardation in patients with cardiac malformations occurs after 34 week of pregnancy.

[Cardiac diseases and pregnancy]. / Choroby serca a ciaza.

Physiological maternal changes during pregnancy and cardiac disease symptoms are described. Prediction of good fetal outcome and delivery in the pregnant patient suffering from cardiac disease requires accurate assessment of cardiac disease advancement, its type and severity, frequent follow-up and immediate intervention in any case of worsening. Concerning chances and risks further influence of pregnancy and delivery on cardiac disease in the mother should be included.

[Pregnancy duration and mode of delivery in patients with cardiac insufficiency on the material of Jagiellonian University OB/GYN Clinic in the years between 1986-1999]. / Czas trwania ciazy i sposób rozwiazania w grupie pacjentek z wadami serca w materiale Kliniki Ginekologii i Poloznictwa Colegium Medicum Uniwersytetu Jagiellonskiego.

OBJECTIVES: Recent progress in cardiology and cardiac surgery lead many patients with cardiac disease in the procreative age. DESIGN: To asses the influence of cardiac disease on pregnancy and delivery. MATERIAL AND METHODS: 232 subjects with congenital and acquired cardiac anomalies, hospitalized in the Jagiellonian University OB/GYN Clinic between 1986-1999. Patients were divided according to NYHA classification depending on kind and grade of cardiovascular insufficiency. Acquired data were compared with data in the control group consisted of 424 subjects without any complications during pregnancy and delivery. RESULTS: We proved shortening of the pregnancy duration in more advanced NYHA classes. Percentage shave of preterm deliveries in 3rd and 4th class was 31.15%, what equals to 3 times preterm delivery rate in the control group. Preterm delivery rate in groups of NYHA I and II was similar to the rate in the control group. Acquired data reveal extremely high cesarean section rate in the material of patients with cardiac anomalies. Cesarean section rate in the group of NYHA I and II was 3 times higher (30%) than in control group (rate of 10%). NYHA III and IV groups has a cesarean section rate of 93%. Vaginal delivery rate in the NYHA I and II groups equals to 58.5%, what is 10 times higher than in NYHA III and IV groups (equals to 6.6%). CONCLUSIONS: 1. Pregnancy duration depends on cardiovascular sufficiency and is significantly shorten in NYHA III and IV groups. 2. Extremely high cesarean section rate in the analyzed group is due to decreased cardiac sufficiency.