Delivery outcomes in women with congenital heart disease: results from the Cuban National Programme for pregnancy and heart disease
ObjectiveTo inform on delivery outcomes achieved in congenital heart disease (CHD) patients by the Cuban National Programme for pregnancy and heart disease.MethodsSingle centre retrospective study on a prospectively collected cardiac pregnancy database at a tertiary referral hospital (January 2000 May 2017) Primary outcomes: pregnancy duration, outcome, maternal/fetal complications.ResultsFour hundred sixty seven pregnancies in 462 recorded cases reached third trimester. Median age: 25 (21 29) years. Patients presented in NYHA class I (97% n 453) or II (3% n 14) 6% (n 27) had arrhythmias, 1% (n 4) had co morbidities, 1% (n 4) had impaired left ventricular function. There were 464 singleton pregnancies and 3 twin pregnancies. Of the singleton pregnancies, one resulted in stillbirth (0.2% The rest were live births (n 463) median weight 3200 (2900 3421) grams. Median pregnancy duration: 39.1 (38.6 40) weeks. Caesarean rate: 34% (n 156) All twin pregnancies (n 3) resulted in live births (n 6) via caesarean section, of median weight 2710 (2458 2850) grams and median pregnancy duration 37 (36 38) weeks. Maternal cardiovascular complications 0.5% n 2) and obstetric complications (14% n 67) did not result in any mortality. Small for gestational age was the commonest neonatal complication (10% n 48) with zero mortality. Three neonates (1% had CHD. Post delivery maternal NYHA functional status: class I in 84% (n 393) class II in 16% (n 73) and class III in one patient 0.5%.ConclusionIn middle income countries management of CHD pregnancies according to existing guidelines can achieve good maternal and fetal outcomes.
Journal of Congenital Cardiology