Uteroplacental Blood Flow, Cardiac Function, and Pregnancy Outcome in Women With Congenital Heart Disease

Author:

Pieper Petronella G.1,Balci Ali1,Aarnoudse Jan G.1,Kampman Marlies A.M.1,Sollie Krystyna M.1,Groen Henk1,Mulder Barbara J.M.1,Oudijk Martijn A.1,Roos-Hesselink Jolien W.1,Cornette Jerome1,van Dijk Arie P.J.1,Spaanderman Marc E.1,Drenthen Willem1,van Veldhuisen Dirk J.1

Affiliation:

1. From the Departments of Cardiology (P.G.P., A.B., M.A.M.K., W.D., D.J.v.V.), Obstetrics (J.G.A., K.M.S.), and Epidemiology (H.G.), University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands; The Netherlands Heart Institute (ICIN), Utrecht, The Netherlands (A.B., M.A.M.K.); Department of Cardiology, Isala, Zwolle, The Netherlands (A.B.); Department of Cardiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands (B.J.M.M.); Department of...

Abstract

Background— Pregnant women with congenital heart disease (CHD) are susceptible to cardiovascular, obstetric, and offspring complications. In women with CHD, cardiac dysfunction may compromise uteroplacental flow and contribute to the increased incidence of obstetric and offspring events. Methods and Results— We performed a prospective multicenter cohort study of pregnant women with CHD and healthy pregnant women. We compared clinical, laboratory, echocardiographic, and uteroplacental Doppler flow (UDF) parameters at 20 and 32 weeks gestation, and pregnancy outcome. We related cardiovascular parameters to UDF parameters and pregnancy outcome in women with CHD. We included 209 women with CHD and 70 healthy women. Cardiovascular parameters (N-terminal pro-B-type natriuretic peptide, left and right ventricular function) differed between both groups. UDF parameters were impaired in CHD women (umbilical artery pulsatility and resistance index at 32 weeks in CHD versus healthy women, P =0.0085 and P =0.017). The following cardiovascular parameters prepregnancy and at 20 weeks gestation were associated with UDF (umbilical artery resistance index) at 32 weeks at multivariable analysis: (1) right ventricular function (tricuspid annular plane systolic excursion) ( P =0.002), (2) high N-terminal pro-B-type natriuretic peptide ( P =0.085), (3) systemic ( P =0.001), and (4) pulmonary ( P =0.045) atrioventricular valve regurgitation. Women with CHD had more obstetric (58.9% versus 32.9%, P <0.0001) and offspring events (35.4% versus 18.6%, P =0.008) than healthy women. Impaired UDF was associated with adverse obstetric and offspring outcome. Conclusions— UDF parameters are abnormal in pregnant women with CHD. Cardiovascular function is associated with an abnormal pattern of UDF. Compromised UDF may be a key factor in the high incidence of offspring and obstetric complications in this population.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3