Research Article
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Year 2025, Volume: 11 Issue: 2, 151 - 160
https://doi.org/10.18621/eurj.1626635

Abstract

References

  • 1. Eggleton EJ, McMurrugh KJ, Aiken CE. Perinatal outcomes in pregnancies complicated by maternal cardiomyopathy: a systematic review and meta-analysis. Am J Obstet Gynecol. 2023;228(3):283-291. doi: 10.1016/j.ajog.2022.09.025.
  • 2. Knight M, Nair M, Brocklehurst P, et al. Examining the impact of introducing ICD-MM on observed trends in maternal mortality rates in the UK 2003-13. BMC Pregnancy Childbirth. 2016;16(1):178. doi: 10.1186/s12884-016-0959-z.
  • 3. Yucel A, Koksal Z, Ensari T, et al. Maternal mortality due to valvular heart disease: a population-based study in Turkey. Ir J Med Sci. 2022;191(6):2531-2537. doi: 10.1007/s11845-021-02879-7.
  • 4. Múnera-Echeverri AG. [Heart disease and pregnancy]. Rev Colomb Cardiol. 2018;25(S1):49-58. doi: 10.1016/j.rccar.2017.11.028. [Article in Spanish]
  • 5. Nguyen Manh T, Bui Van N, Le Thi H, et al. Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction. Int J Environ Res Public Health. 2019;16(12):2075. doi: 10.3390/ijerph16122075.
  • 6. Kearney K, Zentner D, Cordina R. Management of Maternal Complex Congenital Heart Disease During Pregnancy. Curr Heart Fail Rep. 2021;18(6):353-361. doi: 10.1007/s11897-021-00534-x.
  • 7. Chapman AB, Abraham WT, Zamudio S, et al. Temporal relationships between hormonal and hemodynamic changes in early human pregnancy. Kidney Int. 1998;54(6):2056-2063. doi: 10.1046/j.1523-1755.1998.00217.x.
  • 8. Mahendru AA, Everett TR, Wilkinson IB, Lees CC, McEniery CM. A longitudinal study of maternal cardiovascular function from preconception to the postpartum period. J Hypertens. 2014;32(4):849-856. doi: 10.1097/HJH.0000000000000090.
  • 9. Parsonage WA, Zentner D, Lust K, Kane SC, Sullivan EA. Heart Disease and Pregnancy: The Need for a Twenty-First Century Approach to Care…. Heart Lung Circ. 2021;30(1):45-51. doi: 10.1016/j.hlc.2020.06.021.
  • 10. Gelson E, Johnson M. Effect of maternal heart disease on pregnancy outcomes. Expert Rev Obstet Gynecol. 2010;5(5):605-617. doi: 10.1586/eog.10.49.
  • 11. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39(34):3165-3241. doi: 10.1093/eurheartj/ehy340.
  • 12. Lammers AE, Diller G-P, Lober R, et al. Maternal and neonatal complications in women with congenital heart disease: a nationwide analysis. Eur Heart J. 2021;42(41):4252-4260. doi: 10.1093/eurheartj/ehab571.
  • 13. Meng M-L, Arendt KW. Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations. Anesthesiology. 2021;135(1):164-183. doi: 10.1097/ALN.0000000000003833.
  • 14. Vural T, Bayraktar B, Yildirim Karaca S, et al. Comparison of Maternal, Perinatal, and Neonatal Outcomes of Asymptomatic and Symptomatic Pregnant Women with Coronavirus Disease-2019. Medeni Med J. 2022;37(1):44-53. doi: 10.4274/MMJ.galenos.2022.47600.
  • 15. Gonzalez JM, Harris I, Jimenez Ramirez N, et al. Maternal cardiac disease and perinatal outcomes in a single tertiary care center. J Matern Fetal Neonatal Med. 2023;36(2):2223336. doi: 10.1080/14767058.2023.2223336.
  • 16. Foeller ME, Foeller TM, Druzin M. Maternal Congenital Heart Disease in Pregnancy. Obstet Gynecol Clin North Am. 2018;45(2):267-280. doi: 10.1016/j.ogc.2018.01.011.
  • 17. Arnoni RT, Arnoni AS, Bonini RCA, et al. Risk factors associated with cardiac surgery during pregnancy. Ann Thorac Surg. 2003;76(5):1605-1608. doi: 10.1016/S0003-4975(03)01188-3.
  • 18. Subbaiah M, Sharma V, Kumar S, et al. Heart disease in pregnancy: cardiac and obstetric outcomes. Arch Gynecol Obstet. 2013;288(1):23-27. doi: 10.1007/s00404-013-2730-2.
  • 19. Madazli R, Sal V, Cift T, Guralp O, Goymen A. Pregnancy outcomes in women with heart disease. Arch Gynecol Obstet. 2010;281(1):29-34. doi: 10.1007/s00404-009-1050-z.
  • 20. Drenthen W, Pieper PG, Roos-Hesselink JW, et al.; ZAHARA Investigators. Outcome of Pregnancy in Women With Congenital Heart Disease: A Literature Review. J Am Coll Cardiol. 2007;49(24):2303-2311. doi: 10.1016/j.jacc.2007.03.027.
  • 21. Beaton A, Okello E, Scheel A, et al. Impact of heart disease on maternal, fetal and neonatal outcomes in a low-resource setting. Heart. 2019;105(10):755-760. doi: 10.1136/heartjnl-2018-313810.
  • 22. Liaw J, Walker B, Hall L, Gorton S, White AV, Heal C. Rheumatic heart disease in pregnancy and neonatal outcomes: A systematic review and meta-analysis. PloS One. 2021;16(6):e0253581. doi: 10.1371/journal.pone.0253581.
  • 23. Khanna R, Chandra D, Yadav S, et al. Maternal and fetal outcomes in pregnant females with rheumatic heart disease. Indian Heart J. 2021;73(2):185-189. doi: 10.1016/j.ihj.2021.01.012.
  • 24. Rezk M, Gamal A.: Maternal and fetal outcome in women with rheumatic heart disease: a 3-year observational study. Arch Gynecol Obstet. 2016;294:273-278. doi: 10.1007/s00404-015-3990-9. Retracted Article.

Maternal heart disease and pregnancy complications: a tertiary hospital experience from Turkiye

Year 2025, Volume: 11 Issue: 2, 151 - 160
https://doi.org/10.18621/eurj.1626635

Abstract

Objectives: Maternal heart disease is a leading cause of non-obstetric maternal mortality and morbidity, complicating the necessary physiological changes during pregnancy. This study aimed to evaluate maternal and perinatal outcomes in pregnancies complicated by maternal heart disease.

Methods: A retrospective analysis was conducted from November 2022 to November 2023 at a tertiary care hospital. Ninety-three pregnant women with maternal heart disease were included and categorized into congenital heart disease, rheumatic heart disease, and other cardiac conditions. Data on demographics, obstetric complications, and perinatal outcomes were analyzed.

Results: Among the participants, 47.3% had rheumatic heart disease, 37.6% had other cardiac conditions, and 15.1% had congenital heart disease. Maternal outcomes included a 29% incidence of preterm delivery, and an 8.6% occurrence of fetal growth restriction, and 7.5% of mothers requiring postpartum intensive care. However, no maternal mortality was observed. Neonatal outcomes included a 30.3% admission rate to the neonatal intensive care unit and a 12.9% incidence of respiratory distress syndrome, with no recorded fetal mortality. Outcomes were consistent across the three cardiac disease groups, demonstrating the effectiveness of multidisciplinary care approaches.

Conclusions: Early diagnosis, individualized care, and multidisciplinary management are essential for improving outcomes in pregnancies with maternal heart disease. Despite no observed maternal or fetal mortality, high rates of preterm births and neonatal complications emphasize the need for targeted interventions. Addressing modifiable risk factors like hypertension and obesity is critical. Multicenter studies with larger cohorts are recommended to enhance management strategies.

Ethical Statement

The study was conducted in accordance with the principles specified in the Declaration of Helsinki. The Ankara Etlik City Hospital’s Ethics Committee gave its permission to the study protocol (approval number: 2023-474 and date: 16.08.2023).

References

  • 1. Eggleton EJ, McMurrugh KJ, Aiken CE. Perinatal outcomes in pregnancies complicated by maternal cardiomyopathy: a systematic review and meta-analysis. Am J Obstet Gynecol. 2023;228(3):283-291. doi: 10.1016/j.ajog.2022.09.025.
  • 2. Knight M, Nair M, Brocklehurst P, et al. Examining the impact of introducing ICD-MM on observed trends in maternal mortality rates in the UK 2003-13. BMC Pregnancy Childbirth. 2016;16(1):178. doi: 10.1186/s12884-016-0959-z.
  • 3. Yucel A, Koksal Z, Ensari T, et al. Maternal mortality due to valvular heart disease: a population-based study in Turkey. Ir J Med Sci. 2022;191(6):2531-2537. doi: 10.1007/s11845-021-02879-7.
  • 4. Múnera-Echeverri AG. [Heart disease and pregnancy]. Rev Colomb Cardiol. 2018;25(S1):49-58. doi: 10.1016/j.rccar.2017.11.028. [Article in Spanish]
  • 5. Nguyen Manh T, Bui Van N, Le Thi H, et al. Pregnancy with Heart Disease: Maternal Outcomes and Risk Factors for Fetal Growth Restriction. Int J Environ Res Public Health. 2019;16(12):2075. doi: 10.3390/ijerph16122075.
  • 6. Kearney K, Zentner D, Cordina R. Management of Maternal Complex Congenital Heart Disease During Pregnancy. Curr Heart Fail Rep. 2021;18(6):353-361. doi: 10.1007/s11897-021-00534-x.
  • 7. Chapman AB, Abraham WT, Zamudio S, et al. Temporal relationships between hormonal and hemodynamic changes in early human pregnancy. Kidney Int. 1998;54(6):2056-2063. doi: 10.1046/j.1523-1755.1998.00217.x.
  • 8. Mahendru AA, Everett TR, Wilkinson IB, Lees CC, McEniery CM. A longitudinal study of maternal cardiovascular function from preconception to the postpartum period. J Hypertens. 2014;32(4):849-856. doi: 10.1097/HJH.0000000000000090.
  • 9. Parsonage WA, Zentner D, Lust K, Kane SC, Sullivan EA. Heart Disease and Pregnancy: The Need for a Twenty-First Century Approach to Care…. Heart Lung Circ. 2021;30(1):45-51. doi: 10.1016/j.hlc.2020.06.021.
  • 10. Gelson E, Johnson M. Effect of maternal heart disease on pregnancy outcomes. Expert Rev Obstet Gynecol. 2010;5(5):605-617. doi: 10.1586/eog.10.49.
  • 11. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;39(34):3165-3241. doi: 10.1093/eurheartj/ehy340.
  • 12. Lammers AE, Diller G-P, Lober R, et al. Maternal and neonatal complications in women with congenital heart disease: a nationwide analysis. Eur Heart J. 2021;42(41):4252-4260. doi: 10.1093/eurheartj/ehab571.
  • 13. Meng M-L, Arendt KW. Obstetric Anesthesia and Heart Disease: Practical Clinical Considerations. Anesthesiology. 2021;135(1):164-183. doi: 10.1097/ALN.0000000000003833.
  • 14. Vural T, Bayraktar B, Yildirim Karaca S, et al. Comparison of Maternal, Perinatal, and Neonatal Outcomes of Asymptomatic and Symptomatic Pregnant Women with Coronavirus Disease-2019. Medeni Med J. 2022;37(1):44-53. doi: 10.4274/MMJ.galenos.2022.47600.
  • 15. Gonzalez JM, Harris I, Jimenez Ramirez N, et al. Maternal cardiac disease and perinatal outcomes in a single tertiary care center. J Matern Fetal Neonatal Med. 2023;36(2):2223336. doi: 10.1080/14767058.2023.2223336.
  • 16. Foeller ME, Foeller TM, Druzin M. Maternal Congenital Heart Disease in Pregnancy. Obstet Gynecol Clin North Am. 2018;45(2):267-280. doi: 10.1016/j.ogc.2018.01.011.
  • 17. Arnoni RT, Arnoni AS, Bonini RCA, et al. Risk factors associated with cardiac surgery during pregnancy. Ann Thorac Surg. 2003;76(5):1605-1608. doi: 10.1016/S0003-4975(03)01188-3.
  • 18. Subbaiah M, Sharma V, Kumar S, et al. Heart disease in pregnancy: cardiac and obstetric outcomes. Arch Gynecol Obstet. 2013;288(1):23-27. doi: 10.1007/s00404-013-2730-2.
  • 19. Madazli R, Sal V, Cift T, Guralp O, Goymen A. Pregnancy outcomes in women with heart disease. Arch Gynecol Obstet. 2010;281(1):29-34. doi: 10.1007/s00404-009-1050-z.
  • 20. Drenthen W, Pieper PG, Roos-Hesselink JW, et al.; ZAHARA Investigators. Outcome of Pregnancy in Women With Congenital Heart Disease: A Literature Review. J Am Coll Cardiol. 2007;49(24):2303-2311. doi: 10.1016/j.jacc.2007.03.027.
  • 21. Beaton A, Okello E, Scheel A, et al. Impact of heart disease on maternal, fetal and neonatal outcomes in a low-resource setting. Heart. 2019;105(10):755-760. doi: 10.1136/heartjnl-2018-313810.
  • 22. Liaw J, Walker B, Hall L, Gorton S, White AV, Heal C. Rheumatic heart disease in pregnancy and neonatal outcomes: A systematic review and meta-analysis. PloS One. 2021;16(6):e0253581. doi: 10.1371/journal.pone.0253581.
  • 23. Khanna R, Chandra D, Yadav S, et al. Maternal and fetal outcomes in pregnant females with rheumatic heart disease. Indian Heart J. 2021;73(2):185-189. doi: 10.1016/j.ihj.2021.01.012.
  • 24. Rezk M, Gamal A.: Maternal and fetal outcome in women with rheumatic heart disease: a 3-year observational study. Arch Gynecol Obstet. 2016;294:273-278. doi: 10.1007/s00404-015-3990-9. Retracted Article.
There are 24 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Original Articles
Authors

Gülşan Karabay 0000-0003-2567-2850

Zeynep Şeyhanlı 0000-0003-3924-3723

Ahmet Arif Filiz 0000-0002-6137-0270

Hatice Ayhan 0009-0000-0186-823X

Selma İpek 0009-0001-4809-9236

Umut Karabay 0000-0002-9632-360X

Ali Çağlar 0000-0002-7022-3029

Early Pub Date February 12, 2025
Publication Date
Submission Date January 24, 2025
Acceptance Date February 9, 2025
Published in Issue Year 2025 Volume: 11 Issue: 2

Cite

AMA Karabay G, Şeyhanlı Z, Filiz AA, Ayhan H, İpek S, Karabay U, Çağlar A. Maternal heart disease and pregnancy complications: a tertiary hospital experience from Turkiye. Eur Res J. 11(2):151-160. doi:10.18621/eurj.1626635

e-ISSN: 2149-3189 


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