Studies in pre-existing heart disease and pregnancy
File(s)
Author(s)
Curry, Ruth
Type
Thesis or dissertation
Abstract
Aims: To study the effect of pre-existing maternal cardiac disease on
cardiovascular function during pregnancy, and on obstetric and
fetal/neonatal outcomes, and to investigate maternal risk factors for
adverse events.
Methods: Retrospective case note review.
Results: Four hundred and eighty-nine pregnancies in 326 women were studied.
Most pregnancies (50%) occurred in women with congenital heart
disease. There were 4 maternal deaths, 6 stillbirths and 5 neonatal
deaths. Cardiovascular events occurred in 7.4% of pregnancies, while
obstetric and perinatal complications occurred in 34% and 30% of
pregnancies respectively.
Conclusions: Pregnancy in women with pre-existing heart disease continues to be
associated with high rates of maternal and neonatal mortality and
morbidity. This work highlights the importance of effective prepregnancy
counselling and meticulous surveillance during pregnancy,
delivery and the puerperium by an experienced multidisciplinary team.
Additionally there is an urgent need for well-designed randomisedcontrolled
trials to determine best practice.
cardiovascular function during pregnancy, and on obstetric and
fetal/neonatal outcomes, and to investigate maternal risk factors for
adverse events.
Methods: Retrospective case note review.
Results: Four hundred and eighty-nine pregnancies in 326 women were studied.
Most pregnancies (50%) occurred in women with congenital heart
disease. There were 4 maternal deaths, 6 stillbirths and 5 neonatal
deaths. Cardiovascular events occurred in 7.4% of pregnancies, while
obstetric and perinatal complications occurred in 34% and 30% of
pregnancies respectively.
Conclusions: Pregnancy in women with pre-existing heart disease continues to be
associated with high rates of maternal and neonatal mortality and
morbidity. This work highlights the importance of effective prepregnancy
counselling and meticulous surveillance during pregnancy,
delivery and the puerperium by an experienced multidisciplinary team.
Additionally there is an urgent need for well-designed randomisedcontrolled
trials to determine best practice.
Version
Open Access
Date Issued
2014-09
Online Publication Date
2017-02-28T07:00:23Z
2017-03-02T14:28:35Z
Date Awarded
2016-03
Advisor
Johnson, Mark
Publisher Department
Department of Surgery & Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Medicine (Research) MD (Res)