Pregnancy Outcome in Eisenmenger Syndrome at an Indian Tertiary Center

Aim: To evaluate the materno-fetal outcome of pregnancy with Eisenmenger syndrome (ES).Materials and methods: This retrospective observational study was carried out at a tertiary teaching institute over a 1-year period.The occurrence of ES in pregnant women with the cardiac disease along with their materno-fetal outcomes was analyzed.Results: Among 27,259 antenatal women who delivered over a period of 1 year, 104 had cardiac disease with 31 congenital heart disease (CHD).Only three cases of pregnancies with ES were found among 104.Thus, ES was seen in 1:9086 pregnant women, 1:35 pregnant women with cardiac disorders, and 1:10 pregnant women with CHD.The mean age was 25.3 ± 0.58 years while the mean gestational age (GA) at delivery was 35.23 ± 0.67 weeks.The mean pulmonary arterial pressure was 68.7 ± 13.3 mm Hg.All had preterm deliveries.Vaginal delivery was conducted in 66.7% while 33.3% had a cesarean delivery.No maternal mortality was seen.Fetal demise was seen in one of three cases.Conclusion: Multidisciplinary care with the availability of a critical care unit can help achieve a positive materno-fetal outcome in ES during pregnancy which till now has been known to have a very high mortality rate.Clinical significance: Of all CHD in pregnancy, ES is associated with a very high maternal mortality rate.However, with multidisciplinary effort and approach, optimum outcomes are achievable.