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Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)

OBJECTIVE: Ebstein’s anomaly is a rare congenital cardiac condition and data regarding pregnancy outcomes in this patient group are scarce. We evaluated the maternal and perinatal risks of pregnancy in 81 women with Ebstein’s anomaly. METHODS: The Registry of Pregnancy and Cardiac disease is a prosp...

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Autores principales: van der Zande, Johanna A, Tutarel, Oktay, Ramlakhan, Karishma P, van der Bosch, Annemien E, Bordese, Roberto, Zengin, Elvin, Wagner, William E, de Sousa, Lidia, Clifford, Piers, Johnson, Mark R, Hall, Roger, Roos-Hesselink, Jolien W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407418/
https://www.ncbi.nlm.nih.gov/pubmed/37550057
http://dx.doi.org/10.1136/openhrt-2023-002406
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author van der Zande, Johanna A
Tutarel, Oktay
Ramlakhan, Karishma P
van der Bosch, Annemien E
Bordese, Roberto
Zengin, Elvin
Wagner, William E
de Sousa, Lidia
Clifford, Piers
Johnson, Mark R
Hall, Roger
Roos-Hesselink, Jolien W
author_facet van der Zande, Johanna A
Tutarel, Oktay
Ramlakhan, Karishma P
van der Bosch, Annemien E
Bordese, Roberto
Zengin, Elvin
Wagner, William E
de Sousa, Lidia
Clifford, Piers
Johnson, Mark R
Hall, Roger
Roos-Hesselink, Jolien W
author_sort van der Zande, Johanna A
collection PubMed
description OBJECTIVE: Ebstein’s anomaly is a rare congenital cardiac condition and data regarding pregnancy outcomes in this patient group are scarce. We evaluated the maternal and perinatal risks of pregnancy in 81 women with Ebstein’s anomaly. METHODS: The Registry of Pregnancy and Cardiac disease is a prospective global registry of pregnancies in women with structural cardiac disease. Pregnancy outcomes in women with Ebstein’s anomaly were examined. The primary outcome was the occurrence of a major adverse cardiac event (MACE) defined as maternal mortality, heart failure, arrhythmia, thromboembolic event or endocarditis. Secondary endpoints were obstetric and perinatal outcomes and the influence of pregnancy on tricuspid valve regurgitation as well as right atrial and ventricular dimensions. RESULTS: In the 81 women with Ebstein’s anomaly (mean age 29.7±6.1 years, 46.9% nulliparous), MACE occurred in 8 (9.9%) pregnancies, mostly heart failure (n=6). There were no maternal deaths. Prepregnancy signs of heart failure were predictive for MACE. Almost half of the women were delivered by caesarean section (45.7%) and preterm delivery occurred in 24.7%. Neonatal mortality was 2.5% and 4.9% of the infants had congenital heart disease. In the subgroup in which prepregnancy and postpregnancy data were available, there was no difference in tricuspid valve regurgitation grade or right atrial and ventricular dimensions before and after pregnancy. CONCLUSIONS: Most women with Ebstein’s anomaly tolerate pregnancy well, but women with prepregnancy signs of heart failure are at higher risk for MACE during pregnancy and should be counselled accordingly.
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spelling pubmed-104074182023-08-09 Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC) van der Zande, Johanna A Tutarel, Oktay Ramlakhan, Karishma P van der Bosch, Annemien E Bordese, Roberto Zengin, Elvin Wagner, William E de Sousa, Lidia Clifford, Piers Johnson, Mark R Hall, Roger Roos-Hesselink, Jolien W Open Heart Congenital Heart Disease OBJECTIVE: Ebstein’s anomaly is a rare congenital cardiac condition and data regarding pregnancy outcomes in this patient group are scarce. We evaluated the maternal and perinatal risks of pregnancy in 81 women with Ebstein’s anomaly. METHODS: The Registry of Pregnancy and Cardiac disease is a prospective global registry of pregnancies in women with structural cardiac disease. Pregnancy outcomes in women with Ebstein’s anomaly were examined. The primary outcome was the occurrence of a major adverse cardiac event (MACE) defined as maternal mortality, heart failure, arrhythmia, thromboembolic event or endocarditis. Secondary endpoints were obstetric and perinatal outcomes and the influence of pregnancy on tricuspid valve regurgitation as well as right atrial and ventricular dimensions. RESULTS: In the 81 women with Ebstein’s anomaly (mean age 29.7±6.1 years, 46.9% nulliparous), MACE occurred in 8 (9.9%) pregnancies, mostly heart failure (n=6). There were no maternal deaths. Prepregnancy signs of heart failure were predictive for MACE. Almost half of the women were delivered by caesarean section (45.7%) and preterm delivery occurred in 24.7%. Neonatal mortality was 2.5% and 4.9% of the infants had congenital heart disease. In the subgroup in which prepregnancy and postpregnancy data were available, there was no difference in tricuspid valve regurgitation grade or right atrial and ventricular dimensions before and after pregnancy. CONCLUSIONS: Most women with Ebstein’s anomaly tolerate pregnancy well, but women with prepregnancy signs of heart failure are at higher risk for MACE during pregnancy and should be counselled accordingly. BMJ Publishing Group 2023-08-07 /pmc/articles/PMC10407418/ /pubmed/37550057 http://dx.doi.org/10.1136/openhrt-2023-002406 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Congenital Heart Disease
van der Zande, Johanna A
Tutarel, Oktay
Ramlakhan, Karishma P
van der Bosch, Annemien E
Bordese, Roberto
Zengin, Elvin
Wagner, William E
de Sousa, Lidia
Clifford, Piers
Johnson, Mark R
Hall, Roger
Roos-Hesselink, Jolien W
Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)
title Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)
title_full Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)
title_fullStr Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)
title_full_unstemmed Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)
title_short Pregnancy outcomes in women with Ebstein’s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)
title_sort pregnancy outcomes in women with ebstein’s anomaly: data from the registry of pregnancy and cardiac disease (ropac)
topic Congenital Heart Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407418/
https://www.ncbi.nlm.nih.gov/pubmed/37550057
http://dx.doi.org/10.1136/openhrt-2023-002406
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