Pregnancy and Congenital Heart Disease: The Magee-Women's Hospital

This paper reports recent maternal and fetal outcomes in a gravid population with significant maternal congenital heart disease. The study was a retrospective single institutional review of all pregnant women with significant congenital heart disease seen hy the authors from 1989 to 1994. Outcomes grouped by a lesion's hemodynamic effect, New York Heart Association (NYHA) functional classification, and presence of maternal cyanosis were noted. There were 61 patients and 111 pregnancies. The degree to which a lesion was hemodynamically significant (minimal, moderate, or severe) was inversely related to the percent of term live birrhs and positively related to both maternal morbidity and NYHA functional class deterioration. Further, there were ten successful term pregnancies to cyanotic women in NYHA functional class II vs. none to cyanotic women in functional class III. For any given maternal congenital heart lesion multiple factors, including hemodynamics, functional class, and presence of cyanosis, should be considered in patient management.