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MATERNAL KALP HASTALIĞI OLAN 115 GEBELİK OLGUSUNUN SONUÇLARI

Yıl 2020, Cilt: 83 Sayı: 1, 17 - 22, 13.01.2020
https://doi.org/10.26650/IUITFD.2019.0031

Öz

Amaç: Maternal kalp hastalığı bulunan gebeliklerin sonuçlarını değerlendirmek. Gereç ve Yöntem: 2013-2018 yılları arasında bir kliniğimizdeki 115 maternal kalp hastalığı olan olgunun sonuçları retrospektif olarak incelenmiştir. Olgular değerlendirilirken kalp hastalıklarının türü ve New York Kalp Derneği’nin fonksiyonel sınıflaması göz önünde bulundurulmuştur. Bulgular: New York Kalp Derneği sınıflamasına göre hastaların dağılımı evre I için %67,1, evre II için %18,2, evre III–IV için ise %14,7 idi. Maternal ya da perinatal mortalite saptanmadı. Romatizmal ve konjenital kalp hastalıklarının görülme oranı sırasıyla %51,3 ve %27,8 olarak bulundu. Maternal morbidite 18 olguda (%15,6) gözlendi. Ortalama doğum haftası ve doğum kilosu evre I–II fonksiyonel kapasiteli grupta belirgin yüksekti (p<0,001). Maternal morbidite ve yenidoğan yoğun bakım ünitesine kabul oranları ise evre III–IV fonksiyonel kapasiteli grupta belirgin yüksekti (p<0,001). Evre I–II ve evre III–IV grupları arasında sezeryan ile doğum oranları ve fetal gelişim kısıtlılığı görülme sıklığı açısından anlamlı fark saptanmadı (p>0,05). Sonuç: Multidisipliner bir yaklaşımla yönetildiğinde kalp hastalığı bulunan gebelerin çoğunluğunda hem anne hem fetüs için memnun edici sonuçların alınması mümkündür.

Kaynakça

  • 1. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG. 2011;118(suppl 1):1-203.
  • 2. Elkayam U, Goland S, Pieper PG, Silverside CK. High- risk cardiac disease in pregnancy: part I. J Am Coll Cardiol 2016;68:396-410.
  • 3. JCS Joint Working Group Guidelines for indication and management of pregnancy and delivery in women with heart dis- ease (JCS 2010): digest version. Circ J 2012;76:24060.
  • 4. Lima FV, Yang J, Xu J, Stergiopoulos K. National trends and in-hospital outcomes in pregnant women with heart disease in the United States. Am J Cardiol 2017;119:1694700.
  • 5. Opotowsky AR, Siddiqi OK, Webb GD. Trends in hospitalizations for adults with congenital heart disease in the U.S. J Am Coll Cardiol 2009;54:460-7.
  • 6. Owens A, Yang J, Nie L, Lima F, Avila C, Stergiopoulos K. Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease J Am Heart Assoc 2018;7(21):e009395.
  • 7. Ruys TP, Cornette J, Roos-Hesselink JW. Pregnancy and delivery in cardiac disease. J Cardiol 2013;61:107-12.
  • 8. Hameed A, Karralp IS, Tummula PP,Wani OR, Canetti M, Akhter MW, et al.The effects of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol 2001;37:893-9.
  • 9. The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels, 8th ed. New York: Heart Association; 1979.
  • 10. Roos-Hesselink JW, Ruys TP, Stein JI, Thilen U, Webb GD, Niwa K, et al. ROPACInvestigators. Outcome of pregnancy in patients with structural or ischaemicheart disease: results of a registry ofthe European Society of Cardiology. Eur Heart J 2013;34(9):657-65.
  • 11. 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.
  • 12. Abdel-Hady ES, El Shamy M, El Rifai AA, Goda H, AbdelSamad A, Moussa S, et al. Maternal and perinatal outcome of pregnancies complicated by cardiac disease. Int J Gynaecol Obstet 2005;90:21-5.
  • 13. Bhatla N, Lal S, Behera GKriplani A, Mittal S, Agarwal N, et al. Cardiac disease in preg- nancy. Int J Gynaecol Obstet 2003;82:153-9.
  • 14. Avila WS, Rossi EG, Ramires JA, Grinberg M, Bortolotto MR, Zugaib M, et al. Pregnancy in patients with heart disease: experience with 1,000 cases. Clin Cardiol 2003;26:135-42.
  • 15. Köşüş A, Köşüş N, Açıkgöz N, Çapar M. Is there any difference between pregnancy with cardiac disease and normal pregnancy for maternal and fetal outcomes? Genel Tıp Derg 2008;18(2):55-60.
  • 16. Thompson JL, Kuklina EV, Bateman BT, Callaghan WM, James AH, Grotegut CA. Medical and Obstetric Outcomes Among Pregnant Women With Congenital Heart Disease. Obstet Gynecol 2015;126(2): 346-54.
  • 17. Aggarwal N, Suri V, Kaur H, Chopra S, Rohila M, Vijayvergia R. Retrospective analysis of outcome of pregnancy in women with congenital heart disease: single-centre experience from North India. Aust N Z J Obstet Gynaecol 2009;49:376-81.
  • 18. Sidlik R, Sheiner E, Levy A, Wiznitzer A. Effect of maternal congenital heart defects on labor and delivery outcome: a population-based study. J Matern Fetal Neonatal Med 2007;20:211-6.
  • 19. Koregol M, Mahale N, Nayak R, Bhandary A. Maternal and perinatal outcomes of pregnancies complicated by cardiac disease. J Turkish-German Gynecol Assoc 2009;10:30-4.
  • 20. Subbaiah M, Sharma V, Kumar S, Rajeshwari S, Kothari SS, Roy KK, et al. Heart disease in pregnancy: cardiac and obstetric outcomes. Arch Gynecol Obstet 2013;288:23-7.
  • 21. Siu SC, Colman JM, Sorensen S, Smallhorn JF, Farine D, Amankwah KS, et al. Adverse Neonatal and cardiac outcomes are more common in Pregnant women with cardiac disease. Circulation 2002;105(18):2179-84.
  • 22. Wenstrom Katharine D. Protocol 15 Cardiac Disease. In: Queenan JT, Spong CY, Lockwood CJ, eds. Protocols for High-Risk Pregnancies An Evidence-Based Approach. 6th ed. Willey Blackwell; 2015. p. 128-139.
  • 23. Davutoglu E, Yuksel MA, Oncul M, Cebi S, Madazli R. Heart disease and pregnancy: Maternal and fetal otcomes. Turkiye Klinikleri J Gynecol Obst 2015;25(2):10310.

PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE

Yıl 2020, Cilt: 83 Sayı: 1, 17 - 22, 13.01.2020
https://doi.org/10.26650/IUITFD.2019.0031

Öz

Objective: To evaluate the outcomes of pregnancies with maternal heart disease. Materials and Methods: The results of 115 patients in our clinic between 2013 and 2018 were retrospectively analyzed. The type of heart disease and functional classification of the New York Heart Association were taken into consideration when evaluating the cases. Results: According to the New York Heart Association classification, the distribution of patients was 67.1% for stage I, 18.2% for stage II, and 14.7% for stage III–IV. There was no maternal or perinatal mortality. The incidence of rheumatic and congenital heart diseases was 51.3% and 27.8%, respectively. Maternal morbidity was observed in 18 cases (15.6%). Mean gestational age and birth weight were significantly higher in the stage I–II functional capacity group (p<0.001). Maternal morbidity and admission rates to neonatal intensive care unit were significantly higher in the stage III–IV functional capacity group (p<0.001). There was no significant difference between stage I–II and stage III–IV groups in terms of cesarean delivery rates and fetal growth restriction (p>0.05). Conclusion: It is possible to obtain satisfactory results for both mother and fetus in the majority of pregnant women with heart disease when managed with a multidisciplinary approac

Kaynakça

  • 1. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006-2008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG. 2011;118(suppl 1):1-203.
  • 2. Elkayam U, Goland S, Pieper PG, Silverside CK. High- risk cardiac disease in pregnancy: part I. J Am Coll Cardiol 2016;68:396-410.
  • 3. JCS Joint Working Group Guidelines for indication and management of pregnancy and delivery in women with heart dis- ease (JCS 2010): digest version. Circ J 2012;76:24060.
  • 4. Lima FV, Yang J, Xu J, Stergiopoulos K. National trends and in-hospital outcomes in pregnant women with heart disease in the United States. Am J Cardiol 2017;119:1694700.
  • 5. Opotowsky AR, Siddiqi OK, Webb GD. Trends in hospitalizations for adults with congenital heart disease in the U.S. J Am Coll Cardiol 2009;54:460-7.
  • 6. Owens A, Yang J, Nie L, Lima F, Avila C, Stergiopoulos K. Neonatal and Maternal Outcomes in Pregnant Women With Cardiac Disease J Am Heart Assoc 2018;7(21):e009395.
  • 7. Ruys TP, Cornette J, Roos-Hesselink JW. Pregnancy and delivery in cardiac disease. J Cardiol 2013;61:107-12.
  • 8. Hameed A, Karralp IS, Tummula PP,Wani OR, Canetti M, Akhter MW, et al.The effects of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol 2001;37:893-9.
  • 9. The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels, 8th ed. New York: Heart Association; 1979.
  • 10. Roos-Hesselink JW, Ruys TP, Stein JI, Thilen U, Webb GD, Niwa K, et al. ROPACInvestigators. Outcome of pregnancy in patients with structural or ischaemicheart disease: results of a registry ofthe European Society of Cardiology. Eur Heart J 2013;34(9):657-65.
  • 11. 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.
  • 12. Abdel-Hady ES, El Shamy M, El Rifai AA, Goda H, AbdelSamad A, Moussa S, et al. Maternal and perinatal outcome of pregnancies complicated by cardiac disease. Int J Gynaecol Obstet 2005;90:21-5.
  • 13. Bhatla N, Lal S, Behera GKriplani A, Mittal S, Agarwal N, et al. Cardiac disease in preg- nancy. Int J Gynaecol Obstet 2003;82:153-9.
  • 14. Avila WS, Rossi EG, Ramires JA, Grinberg M, Bortolotto MR, Zugaib M, et al. Pregnancy in patients with heart disease: experience with 1,000 cases. Clin Cardiol 2003;26:135-42.
  • 15. Köşüş A, Köşüş N, Açıkgöz N, Çapar M. Is there any difference between pregnancy with cardiac disease and normal pregnancy for maternal and fetal outcomes? Genel Tıp Derg 2008;18(2):55-60.
  • 16. Thompson JL, Kuklina EV, Bateman BT, Callaghan WM, James AH, Grotegut CA. Medical and Obstetric Outcomes Among Pregnant Women With Congenital Heart Disease. Obstet Gynecol 2015;126(2): 346-54.
  • 17. Aggarwal N, Suri V, Kaur H, Chopra S, Rohila M, Vijayvergia R. Retrospective analysis of outcome of pregnancy in women with congenital heart disease: single-centre experience from North India. Aust N Z J Obstet Gynaecol 2009;49:376-81.
  • 18. Sidlik R, Sheiner E, Levy A, Wiznitzer A. Effect of maternal congenital heart defects on labor and delivery outcome: a population-based study. J Matern Fetal Neonatal Med 2007;20:211-6.
  • 19. Koregol M, Mahale N, Nayak R, Bhandary A. Maternal and perinatal outcomes of pregnancies complicated by cardiac disease. J Turkish-German Gynecol Assoc 2009;10:30-4.
  • 20. Subbaiah M, Sharma V, Kumar S, Rajeshwari S, Kothari SS, Roy KK, et al. Heart disease in pregnancy: cardiac and obstetric outcomes. Arch Gynecol Obstet 2013;288:23-7.
  • 21. Siu SC, Colman JM, Sorensen S, Smallhorn JF, Farine D, Amankwah KS, et al. Adverse Neonatal and cardiac outcomes are more common in Pregnant women with cardiac disease. Circulation 2002;105(18):2179-84.
  • 22. Wenstrom Katharine D. Protocol 15 Cardiac Disease. In: Queenan JT, Spong CY, Lockwood CJ, eds. Protocols for High-Risk Pregnancies An Evidence-Based Approach. 6th ed. Willey Blackwell; 2015. p. 128-139.
  • 23. Davutoglu E, Yuksel MA, Oncul M, Cebi S, Madazli R. Heart disease and pregnancy: Maternal and fetal otcomes. Turkiye Klinikleri J Gynecol Obst 2015;25(2):10310.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ARAŞTIRMA
Yazarlar

Ayşegül Özel 0000-0002-0283-1049

Kübra Hamzaoğlu Bu kişi benim 0000-0002-7965-8301

Eser Durmaz Bu kişi benim 0000-0002-1468-0153

Rıza Madazlı Bu kişi benim 0000-0002-6400-1964

Yayımlanma Tarihi 13 Ocak 2020
Gönderilme Tarihi 3 Nisan 2019
Yayımlandığı Sayı Yıl 2020 Cilt: 83 Sayı: 1

Kaynak Göster

APA Özel, A., Hamzaoğlu, K., Durmaz, E., Madazlı, R. (2020). PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE. Journal of Istanbul Faculty of Medicine, 83(1), 17-22. https://doi.org/10.26650/IUITFD.2019.0031
AMA Özel A, Hamzaoğlu K, Durmaz E, Madazlı R. PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE. İst Tıp Fak Derg. Ocak 2020;83(1):17-22. doi:10.26650/IUITFD.2019.0031
Chicago Özel, Ayşegül, Kübra Hamzaoğlu, Eser Durmaz, ve Rıza Madazlı. “PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE”. Journal of Istanbul Faculty of Medicine 83, sy. 1 (Ocak 2020): 17-22. https://doi.org/10.26650/IUITFD.2019.0031.
EndNote Özel A, Hamzaoğlu K, Durmaz E, Madazlı R (01 Ocak 2020) PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE. Journal of Istanbul Faculty of Medicine 83 1 17–22.
IEEE A. Özel, K. Hamzaoğlu, E. Durmaz, ve R. Madazlı, “PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE”, İst Tıp Fak Derg, c. 83, sy. 1, ss. 17–22, 2020, doi: 10.26650/IUITFD.2019.0031.
ISNAD Özel, Ayşegül vd. “PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE”. Journal of Istanbul Faculty of Medicine 83/1 (Ocak 2020), 17-22. https://doi.org/10.26650/IUITFD.2019.0031.
JAMA Özel A, Hamzaoğlu K, Durmaz E, Madazlı R. PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE. İst Tıp Fak Derg. 2020;83:17–22.
MLA Özel, Ayşegül vd. “PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE”. Journal of Istanbul Faculty of Medicine, c. 83, sy. 1, 2020, ss. 17-22, doi:10.26650/IUITFD.2019.0031.
Vancouver Özel A, Hamzaoğlu K, Durmaz E, Madazlı R. PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE. İst Tıp Fak Derg. 2020;83(1):17-22.

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