Cardiac Status of Women with Congenital Heart Disease and Multiple Pregnancies

Introduction: Women with congenital heart disease (CHD) are at risk for obstetric and cardiac complications during pregnancy and delivery. The modified word Health organization (mWHO) scale is considered the best for risk stratification. Most data are derived from first pregnancy outcome. Little is known of the long term cardiac impact of multiple pregnancies in women with CHD.

Methods: We matched and compared women with CHD who had ≥3 deliveries to women who had up to 2 deliveries. Matched women had a similar CHD and repair status, and up to 5 years age difference. Present cardiac status was assessed by NYHA functional classification and a qualitative assessment of ventricular and valve function of a recent echocardiogram scored 1 (normal) through 4 (severely impaired) by a cardiologist blinded to the parity.

Results: There were 29 matched pairs. The cardiac lesions of the pairs: atrial septal defect 9, Tetralogy of Fallot 7, Ventricular septal defect 4, Patent ductus arteriosus 3, Single ventricle S/P Fontan 1, Pulmonary valve stenosis 1, Aortopathy 1. The number of birth in the ≥3 group was 5±2.3 and in the There were no differences in NYHA class (<3, 1.52±0.74; ≥3, 1.45±0.74, p=0.13) and echocardiogram score (<3, 2.14±0.69; ≥3, 2.07±0.75, p=0.8).

Conclusion: In this group of patients, there was no significant difference in NYHA score or echocardiogram score of women with CHD who had ≥ 3 deliveries when compared to women with similar age and lesion who had < 3 deliveries.