Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes

Background Atrial septal aneurysm (ASA) is an uncommon cardiac anomaly that increases maternal morbidity during pregnancy. ASA is related to atrial arrhythmia thromboembolism and it may accompany congenital anomalies such as an atrial septal defect (ASD) or patent foramen ovale (PFO). There are no studies examining pregnancy outcomes in pregnant women with ASA. We aimed to investigate the cardiologic parameters and obstetric outcomes of pregnant women diagnosed with ASA. Methods This prospective cohort study analyzed 45 pregnant women diagnosed with ASA, who continued their follow-ups in an obstetric tertiary care center. Results A total of 45 pregnant women were recruited; seven pregnancies ended before the 20th gestational week (six spontaneous abortion, one fetal anomaly), 38 women gave birth. In total, there were 32 term births (≥37 weeks), six preterm births (<37 weeks), two extremely preterm births <28 weeks). Among 38 babies delivered, several obstetrical complications such as oligohydramnios, spontaneous preterm labor, intrauterine growth restriction (IUGR), preeclampsia and gestational diabetes mellitus (GDM) developed in 16 patients, while 22 women ended with term pregnancy without any complications. Deep venous thrombosis (DVT) developed in one patient. Conclusion ASA may have an increased risk for cardiac complications during pregnancy and may also be associated with poor pregnancy outcomes. Increased attention to these entities with more studies is needed in order to determine a potential risk for pregnant women.