Pregnancy Complicated by Cardiac Disease: Maternal and Perinatal Outcome

We report maternal and perinatal outcome in pregnancies complicated by maternal cardiac disease. A retrospective review of 54 women with cardiac disease, managed through 71 pregnancies from February 1981, through July 1991, was conducted. Tricuspid atresia and pulmonary hypertension were associated with a 50% maternal mortality rate and a 67% incidence of intrauterine growth retardation. Cardiomyopathy was associated with prematurity and low birthweight. Atrial or ventricular septal defects and stenotic lesions of the outflow tracts were generally not associated with adverse maternal or perinatal outcome. Women with previous myocardial infarction, corrected tetralogy of Fallot, aortic or mitral insufficiency, and mitral valve prolapse generally tolerated pergnancy, labor, and delivery without adverse sequelae in this review. Although peripartum cardiomyopathy was associated with low birthweight, pregnancies were successfully managed with intensive monitoring. Tricuspid atresia and pulmonary hypertension remain a significant cause of maternal mortality. In general, pregnancies complicated by cardiac disease result in favorable maternal and fetal outcome.