Obstetric Anesthesia

Complications in Obstetrics and Obstetric Anesthesia

A Growing Problem: Maternal Death and Peripartum Complications Are Higher in Women With Grown-Up Congenital Heart Disease

Karamlou T, Diggs BS, McCrindle BW, et al (Seattle Children’s Hosp, Washington; Oregon Health & Science Univ, Portland; Hosp for Sick Kids, Toronto, Ontario, Canada; et al) Ann Thorac Surg 92:2193-2199, 2011^§

Abstract

Background

As patients with grown-up congenital heart disease (GUCH) increase, more women with GUCH will become pregnant. Heart surgeons may be involved in maternal GUCH care, yet the prevalence, characteristics, and outcomes for these women are unknown. We determined the national prevalence of GUCH parturients, their diagnostic makeup, and whether they have increased risk of peripartum complications, maternal or fetal death.

Methods

We searched the Nationwide Inpatient Sample for women undergoing delivery in the United States between 1998 and 2007, with GUCH patients indicated by a code for “congenital cardiac diagnosis complicating pregnancy,” Patient and hospital characteristics were compared between women with and without GUCH. National estimates for maternal and fetal mortality, cardiac complications, induction, caesarean or surgically assisted birth, and preterm delivery were derived. Outcomes were compared between women with and without GUCH, and also within diagnostic GUCH subgroups.

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