PREGNANCY IN CYANOTIC CONGENITAL HEART-DISEASE - OUTCOME OF MOTHER AND FETUS

In a series of 416 women with congenital heart disease seen in the Roy al Brompton National Heart and Lung Hospital, London, and the Hospital Giovanni Bosco, Torino, Italy, there were 822 pregnancies. The outcom es of 96 pregnancies in 44 patients with cyanotic congenital heart dis ease were studied. Patients with the Eisenmenger reaction were exclude d. Patients were divided arbitrarily into groups according to the type of maternal congenital cardiac anomaly, and factors influencing mater nal and fetal outcome were evaluated. The incidence of maternal cardio vascular complications was high (32%), with one death from endocarditi s 2 months after delivery. Forty-one (43%) of 96 pregnancies resulted in a live birth; 15 (37%) were premature. Mean weight of full-term inf ants was 2575 g. Univariate analysis suggested that maternal disease, Ability Index, hemoglobin, and arterial oxygen Saturation before the p regnancy were factors that discriminated between successful and unsucc essful fetal outcome, with hemoglobin and arterial oxygen saturation b eing the most important predictors. Women with cyanotic congenital hea rt disease can go through pregnancy with a low risk to themselves, wit h frequent treatable complications, but there is a high incidence of m iscarriage, premature births, and low birth weights. An incidence of c ongenital heart disease in the fetus of 4.9% (2 of 41 live births) is higher than that found in the normal population.