PREGNANCY IN WOMEN WITH ACQUIRED HEART DISEASE: COURSE AND OUTCOMES

Objective. To analyze the course and outcomes of pregnancy in women with acquired heart diseases (AHD). Materials and methods. The medical cards and delivery records of 40 pregnant women with AHD were analyzed. The results were statistically processed with a package of Biostatistics Version 4.03 programs, by applying the standard methods of variation statistics and Student’s test. Results. In a group of women with corrected AHD, the latter was revealed later than that in a group of those with uncorrected AHD; these pregnant women were more frequently found to have functional class (FC) II heart failure. The pregnant women with ADH showed chronic intrauterine hypoxia and chronic fetal growth retardation. In the pregnant women with corrected AHD, delivery at term occurred significantly more frequently than in those with uncorrected AHD. In the patients with corrected AHD, their neonates’ body weight was significantly higher than the babies born to those with uncorrected AHD, FC II circulatory insufficiency, or pulmonary hypertension. Healthy neonatal infants were 14.3 and 8.3% in the corrected and uncorrected AHD groups, respectively. Both groups were comparable with respect to the rate of cerebral ischemia (more than 70%). Hyperexcitability and motor disorders were more common in the uncorrected AHD group. Autonomic visceral dysfunctions, incomplete pregnancy, and fetal growth retardation were predominant in the corrected AHD group. Conclusion. Heart failure developing by the end of pregnancy caused chronic intrauterine hypoxia and chronic fetoplacental insufficiency in the pregnant women with AHD. As a result, preterm labor occurred in 80% of cases in the corrected AHD group. Cesarean section as a delivery mode was prevalent, which was due to both cardiac and obstetric diseases. The proportion of healthy newborn infants born to patients with AHD was small (nearly 10%). Different types of neonatal central nervous system diseases were recorded at a high frequency.

pregnancy, acquired heart diseases, outcomes