Key result
Pregnancies in women with long QT syndrome had no maternal cardiovascular events during labor or postpartum, but resulted in a 20% caesarean delivery rate due to non-reassuring fetal heart rate.
Cohort (n=25)
No
Delivery in women with long QT syndrome is associated with a low risk of maternal cardiovascular events, likely due to high beta-blocker use, but carries a higher rate of caesarean delivery due to non-reassuring fetal heart rate patterns.
Supports beta-blocker continuation through delivery in LQTS; leaves open whether targeted fetal monitoring can safely reduce caesarean rates.
OBJECTIVE: Women during labor may be susceptible to torsades de pointes (TdP), which may cause the fetal condition to deteriorate. The aim of the present investigation was to analyze maternal and fetal outcomes during labor when long QT syndrome (LQTS) was present. METHODS: We examined the maternal and neonatal outcomes of 25 pregnancies (18 women) with LQT between 1995 and 2012 at the Department of Perinatology, National Cardiovascular Center, Japan. Maternal and neonatal outcomes including cardiovascular events, cardiovascular events within a week after delivery, caesarean delivery rate, still births, preterm births, and non-reassuring fetal heart rate pattern (NRFHR) during labor were investigated. RESULTS: All the mothers survived, and no cardiovascular events occurred in labor or postpartum due to LQTS in either vaginal delivery or caesarean delivery. A total of 23 women (92%) had used beta blockers in this study. Caesarean delivery was performed due to NRFHR during labor in 5 pregnancies (20%). CONCLUSION: Delivery when LQTS is present has a low likelihood of cardiovascular events, but pregnancy with LQTS had a higher caesarean delivery rate due to NRFHR in labor. Most women used beta blockers in this study, and it is possible that beta blocker use prevents cardiovascular events during labor. NRFHR during labor may be related with inherited LQT through the mother.
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Tanaka et al. (2015) conducted a cohort in Long QT syndrome (n=25). Long QT syndrome was evaluated on Maternal cardiovascular events in labor or postpartum. Pregnancies in women with long QT syndrome had no maternal cardiovascular events during labor or postpartum, but resulted in a 20% caesarean delivery rate due to non-reassuring fetal heart rate.
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