Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center
Identifieur interne : 001E17 ( Main/Corpus ); précédent : 001E16; suivant : 001E18Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center
Auteurs : Waltraut M. Merz ; Mignon-Denise Keyver-Paik ; Georg Baumgarten ; Thorsten Lewalter ; Ulrich GembruchSource :
- Journal of Perinatal Medicine [ 0300-5577 ] ; 2011-05-01.
Abstract
Aim: To analyze the spectrum of cardiovascular diseases occurring during pregnancy and delivery at a tertiary referral center. Methods: All patients presenting at our institution with pre-existing or first diagnosis of cardiac disease were recruited. Cardiac and obstetric complications and maternal and neonatal outcomes were recorded. Results: Fifty-two pregnancies in 49 women, including three pregnancy terminations were analyzed. Cardiac lesions were congenital in 26 (53.1%) and acquired in nine (18.4%); six patients (12.2%) had cardiomyopathies, eight (16.3%) ar-rhythmic conditions. A total of 42 women (85.7%) had a pre-existing cardiac condition and seven (14.3%) presented with first manifestation. Overall 22 cardiac complications occurred: five in pregnancy, eight around parturition, nine during follow-up. They included >1 New York Heart Association functional class deterioration (n=5), congestive heart failure/cardiomyopathy (n=5), valve replacement (n=4), sustained arrhythmia (n=3), cerebral insult, aortic dissection, transplantation (one case each), and death (n=2). Mean gestational age at delivery was 36+6. The cesarean section rate was 77.5%; 31.6% were performed for cardiac indications. Obstetric complications happened in 23 pregnancies (46.9%). There was no perinatal loss; cardiac defects were diagnosed in 9.3% (n=5) of offspring. Conclusion: Cardiovascular diseases occurring during pregnancy and parturition comprise a heterogeneous spectrum of conditions. Established scores aid in the identification of high-risk patients; however, in our series 14.3% women had been healthy previously.
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DOI: 10.1515/jpm.2011.008
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Merz</name><affiliation><mods:affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Keyver Paik, Mignon Denise" sort="Keyver Paik, Mignon Denise" uniqKey="Keyver Paik M" first="Mignon-Denise" last="Keyver-Paik">Mignon-Denise Keyver-Paik</name><affiliation><mods:affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Baumgarten, Georg" sort="Baumgarten, Georg" uniqKey="Baumgarten G" first="Georg" last="Baumgarten">Georg Baumgarten</name><affiliation><mods:affiliation>Department of Anesthesiology and Intensive Care Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Lewalter, Thorsten" sort="Lewalter, Thorsten" uniqKey="Lewalter T" first="Thorsten" last="Lewalter">Thorsten Lewalter</name><affiliation><mods:affiliation>Department of Cardiology, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gembruch, Ulrich" sort="Gembruch, Ulrich" uniqKey="Gembruch U" first="Ulrich" last="Gembruch">Ulrich Gembruch</name><affiliation><mods:affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74</idno><date when="2011" year="2011">2011</date><idno type="doi">10.1515/jpm.2011.008</idno><idno type="url">https://api.istex.fr/document/B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">001E17</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center</title><author><name sortKey="Merz, Waltraut M" sort="Merz, Waltraut M" uniqKey="Merz W" first="Waltraut M." last="Merz">Waltraut M. Merz</name><affiliation><mods:affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Keyver Paik, Mignon Denise" sort="Keyver Paik, Mignon Denise" uniqKey="Keyver Paik M" first="Mignon-Denise" last="Keyver-Paik">Mignon-Denise Keyver-Paik</name><affiliation><mods:affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Baumgarten, Georg" sort="Baumgarten, Georg" uniqKey="Baumgarten G" first="Georg" last="Baumgarten">Georg Baumgarten</name><affiliation><mods:affiliation>Department of Anesthesiology and Intensive Care Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Lewalter, Thorsten" sort="Lewalter, Thorsten" uniqKey="Lewalter T" first="Thorsten" last="Lewalter">Thorsten Lewalter</name><affiliation><mods:affiliation>Department of Cardiology, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author><author><name sortKey="Gembruch, Ulrich" sort="Gembruch, Ulrich" uniqKey="Gembruch U" first="Ulrich" last="Gembruch">Ulrich Gembruch</name><affiliation><mods:affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Perinatal Medicine</title><title level="j" type="abbrev">Journal of Perinatal Medicine</title><idno type="ISSN">0300-5577</idno><idno type="eISSN">1619-3997</idno><imprint><publisher>Walter de Gruyter</publisher><date type="published" when="2011-05-01">2011-05-01</date><biblScope unit="volume">39</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="251">251</biblScope><biblScope unit="page" to="256">256</biblScope></imprint><idno type="ISSN">0300-5577</idno></series><idno type="istex">B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74</idno><idno type="DOI">10.1515/jpm.2011.008</idno><idno type="ArticleID">jpm.2011.008</idno><idno type="Related-article-Href">jpm.2011.008.pdf</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0300-5577</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Aim: To analyze the spectrum of cardiovascular diseases occurring during pregnancy and delivery at a tertiary referral center. Methods: All patients presenting at our institution with pre-existing or first diagnosis of cardiac disease were recruited. Cardiac and obstetric complications and maternal and neonatal outcomes were recorded. Results: Fifty-two pregnancies in 49 women, including three pregnancy terminations were analyzed. Cardiac lesions were congenital in 26 (53.1%) and acquired in nine (18.4%); six patients (12.2%) had cardiomyopathies, eight (16.3%) ar-rhythmic conditions. A total of 42 women (85.7%) had a pre-existing cardiac condition and seven (14.3%) presented with first manifestation. Overall 22 cardiac complications occurred: five in pregnancy, eight around parturition, nine during follow-up. They included >1 New York Heart Association functional class deterioration (n=5), congestive heart failure/cardiomyopathy (n=5), valve replacement (n=4), sustained arrhythmia (n=3), cerebral insult, aortic dissection, transplantation (one case each), and death (n=2). Mean gestational age at delivery was 36+6. The cesarean section rate was 77.5%; 31.6% were performed for cardiac indications. Obstetric complications happened in 23 pregnancies (46.9%). There was no perinatal loss; cardiac defects were diagnosed in 9.3% (n=5) of offspring. Conclusion: Cardiovascular diseases occurring during pregnancy and parturition comprise a heterogeneous spectrum of conditions. Established scores aid in the identification of high-risk patients; however, in our series 14.3% women had been healthy previously.</div></front></TEI><istex><corpusName>degruyter-journals</corpusName><author><json:item><name>Waltraut M. Merz</name><affiliations><json:string>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</json:string></affiliations></json:item><json:item><name>Mignon-Denise Keyver-Paik</name><affiliations><json:string>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</json:string></affiliations></json:item><json:item><name>Georg Baumgarten</name><affiliations><json:string>Department of Anesthesiology and Intensive Care Medicine, University Bonn Medical School, Bonn, Germany</json:string></affiliations></json:item><json:item><name>Thorsten Lewalter</name><affiliations><json:string>Department of Cardiology, University Bonn Medical School, Bonn, Germany</json:string></affiliations></json:item><json:item><name>Ulrich Gembruch</name><affiliations><json:string>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>ORIGINAL ARTICLES - OBSTETRICS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Cardiac disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>CARPREG</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>delivery</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>fetal outcome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>pregnancy</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Aim: To analyze the spectrum of cardiovascular diseases occurring during pregnancy and delivery at a tertiary referral center. Methods: All patients presenting at our institution with pre-existing or first diagnosis of cardiac disease were recruited. Cardiac and obstetric complications and maternal and neonatal outcomes were recorded. Results: Fifty-two pregnancies in 49 women, including three pregnancy terminations were analyzed. Cardiac lesions were congenital in 26 (53.1%) and acquired in nine (18.4%); six patients (12.2%) had cardiomyopathies, eight (16.3%) ar-rhythmic conditions. A total of 42 women (85.7%) had a pre-existing cardiac condition and seven (14.3%) presented with first manifestation. Overall 22 cardiac complications occurred: five in pregnancy, eight around parturition, nine during follow-up. They included >1 New York Heart Association functional class deterioration (n=5), congestive heart failure/cardiomyopathy (n=5), valve replacement (n=4), sustained arrhythmia (n=3), cerebral insult, aortic dissection, transplantation (one case each), and death (n=2). Mean gestational age at delivery was 36+6. The cesarean section rate was 77.5%; 31.6% were performed for cardiac indications. Obstetric complications happened in 23 pregnancies (46.9%). There was no perinatal loss; cardiac defects were diagnosed in 9.3% (n=5) of offspring. Conclusion: Cardiovascular diseases occurring during pregnancy and parturition comprise a heterogeneous spectrum of conditions. Established scores aid in the identification of high-risk patients; however, in our series 14.3% women had been healthy previously.</abstract><qualityIndicators><score>5.656</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595.245 x 793.66 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>1623</abstractCharCount><pdfWordCount>3064</pdfWordCount><pdfCharCount>21908</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>216</abstractWordCount></qualityIndicators><title>Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center</title><genre><json:string>research-article</json:string></genre><host><volume>39</volume><pages><last>256</last><first>251</first></pages><issn><json:string>0300-5577</json:string></issn><issue>3</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1619-3997</json:string></eissn><title>Journal of Perinatal Medicine</title></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1515/jpm.2011.008</json:string></doi><id>B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center</title><respStmt xml:id="ISTEX-API" resp="Références bibliographiques récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Walter de Gruyter</publisher><availability><p>De Gruyter</p></availability><date>2011-04-19</date></publicationStmt><notesStmt><note>Corresponding author: Waltraut M. Merz, MD, PhD, MSc Department of Obstetrics and Prenatal Medicine University Bonn Medical School Sigmund-Freud-Str. 25 D-53105 Bonn Germany Tel.: +49-228-28715449 Fax: +49-228-28716088</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center</title><author><persName><forename type="first">Waltraut M.</forename><surname>Merz</surname></persName><affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</affiliation></author><author><persName><forename type="first">Mignon-Denise</forename><surname>Keyver-Paik</surname></persName><affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</affiliation></author><author><persName><forename type="first">Georg</forename><surname>Baumgarten</surname></persName><affiliation>Department of Anesthesiology and Intensive Care Medicine, University Bonn Medical School, Bonn, Germany</affiliation></author><author><persName><forename type="first">Thorsten</forename><surname>Lewalter</surname></persName><affiliation>Department of Cardiology, University Bonn Medical School, Bonn, Germany</affiliation></author><author><persName><forename type="first">Ulrich</forename><surname>Gembruch</surname></persName><affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</affiliation></author></analytic><monogr><title level="j">Journal of Perinatal Medicine</title><title level="j" type="abbrev">Journal of Perinatal Medicine</title><idno type="pISSN">0300-5577</idno><idno type="eISSN">1619-3997</idno><imprint><publisher>Walter de Gruyter</publisher><date type="published" when="2011-05-01"></date><biblScope unit="volume">39</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="251">251</biblScope><biblScope unit="page" to="256">256</biblScope></imprint></monogr><idno type="istex">B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74</idno><idno type="DOI">10.1515/jpm.2011.008</idno><idno type="ArticleID">jpm.2011.008</idno><idno type="Related-article-Href">jpm.2011.008.pdf</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011-04-19</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Aim: To analyze the spectrum of cardiovascular diseases occurring during pregnancy and delivery at a tertiary referral center. Methods: All patients presenting at our institution with pre-existing or first diagnosis of cardiac disease were recruited. Cardiac and obstetric complications and maternal and neonatal outcomes were recorded. Results: Fifty-two pregnancies in 49 women, including three pregnancy terminations were analyzed. Cardiac lesions were congenital in 26 (53.1%) and acquired in nine (18.4%); six patients (12.2%) had cardiomyopathies, eight (16.3%) ar-rhythmic conditions. A total of 42 women (85.7%) had a pre-existing cardiac condition and seven (14.3%) presented with first manifestation. Overall 22 cardiac complications occurred: five in pregnancy, eight around parturition, nine during follow-up. They included >1 New York Heart Association functional class deterioration (n=5), congestive heart failure/cardiomyopathy (n=5), valve replacement (n=4), sustained arrhythmia (n=3), cerebral insult, aortic dissection, transplantation (one case each), and death (n=2). Mean gestational age at delivery was 36+6. The cesarean section rate was 77.5%; 31.6% were performed for cardiac indications. Obstetric complications happened in 23 pregnancies (46.9%). There was no perinatal loss; cardiac defects were diagnosed in 9.3% (n=5) of offspring. Conclusion: Cardiovascular diseases occurring during pregnancy and parturition comprise a heterogeneous spectrum of conditions. Established scores aid in the identification of high-risk patients; however, in our series 14.3% women had been healthy previously.</p></abstract><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>Cardiac disease</term></item><item><term>CARPREG</term></item><item><term>delivery</term></item><item><term>fetal outcome</term></item><item><term>pregnancy</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-04-19">Created</change><change when="2011-05-01">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-3-13">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus degruyter-journals" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//Atypon//DTD Atypon Systems Archival NLM DTD Suite v2.2.0 20090301//EN" URI="nlm-dtd/archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="publisher-id">jpme</journal-id><abbrev-journal-title abbrev-type="full">Journal of Perinatal Medicine</abbrev-journal-title><issn pub-type="epub">1619-3997</issn><issn pub-type="ppub">0300-5577</issn><publisher><publisher-name>Walter de Gruyter</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jpm.2011.008</article-id><article-id pub-id-type="doi">10.1515/jpm.2011.008</article-id><article-categories><subj-group subj-group-type="heading"><subject>ORIGINAL ARTICLES - OBSTETRICS</subject></subj-group></article-categories><title-group><article-title>Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center</article-title></title-group><contrib-group><contrib contrib-type="author"><name name-style="western"><given-names>Waltraut M.</given-names><x> </x><surname>Merz</surname></name><email>Waltraut.Merz@ukb.uni-bonn.de</email><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><x>, </x></contrib><contrib contrib-type="author"><name name-style="western"><given-names>Mignon-Denise</given-names><x> </x><surname>Keyver-Paik</surname></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><x>, </x></contrib><contrib contrib-type="author"><name name-style="western"><given-names>Georg</given-names><x> </x><surname>Baumgarten</surname></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><x>, </x></contrib><contrib contrib-type="author"><name name-style="western"><given-names>Thorsten</given-names><x> </x><surname>Lewalter</surname></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref><x>, </x></contrib><contrib contrib-type="author"><name name-style="western"><given-names>Ulrich</given-names><x> </x><surname>Gembruch</surname></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><x>, </x></contrib><aff id="aff1"><sup>1</sup>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</aff><aff id="aff2"><sup>2</sup>Department of Anesthesiology and Intensive Care Medicine, University Bonn Medical School, Bonn, Germany</aff><aff id="aff3"><sup>3</sup>Department of Cardiology, University Bonn Medical School, Bonn, Germany</aff></contrib-group><author-notes><corresp>Corresponding author: Waltraut M. Merz, MD, PhD, MSc Department of Obstetrics and Prenatal Medicine University Bonn Medical School Sigmund-Freud-Str. 25 D-53105 Bonn Germany Tel.: +49-228-28715449 Fax: +49-228-28716088</corresp></author-notes><pub-date pub-type="ppub"><day>01</day><month>05</month><year>2011</year><string-date>May 2011</string-date></pub-date><pub-date pub-type="epub"><day>19</day><month>04</month><year>2011</year></pub-date><pub-date pub-type="epub"><day>19</day><month>04</month><year>2011</year></pub-date><volume>39</volume><issue>3</issue><fpage>251</fpage><lpage>256</lpage><history><date date-type="received"><day>24</day><month>8</month><year>2010</year></date><date date-type="rev-recd"><day>12</day><month>10</month><year>2010</year></date><date date-type="accepted"><day>21</day><month>10</month><year>2010</year></date></history><copyright-statement>©2011 by Walter de Gruyter Berlin New York</copyright-statement><copyright-year>2011</copyright-year><related-article related-article-type="pdf" xlink:href="jpm.2011.008.pdf"></related-article><abstract><title>Abstract</title><p><bold>Aim:</bold> To analyze the spectrum of cardiovascular diseases occurring during pregnancy and delivery at a tertiary referral center.</p><p><bold>Methods:</bold> All patients presenting at our institution with pre-existing or first diagnosis of cardiac disease were recruited. Cardiac and obstetric complications and maternal and neonatal outcomes were recorded.</p><p><bold>Results:</bold> Fifty-two pregnancies in 49 women, including three pregnancy terminations were analyzed. Cardiac lesions were congenital in 26 (53.1%) and acquired in nine (18.4%); six patients (12.2%) had cardiomyopathies, eight (16.3%) ar-rhythmic conditions. A total of 42 women (85.7%) had a pre-existing cardiac condition and seven (14.3%) presented with first manifestation. Overall 22 cardiac complications occurred: five in pregnancy, eight around parturition, nine during follow-up. They included >1 New York Heart Association functional class deterioration (n=5), congestive heart failure/cardiomyopathy (n=5), valve replacement (n=4), sustained arrhythmia (n=3), cerebral insult, aortic dissection, transplantation (one case each), and death (n=2). Mean gestational age at delivery was 36+6. The cesarean section rate was 77.5%; 31.6% were performed for cardiac indications. Obstetric complications happened in 23 pregnancies (46.9%). There was no perinatal loss; cardiac defects were diagnosed in 9.3% (n=5) of offspring.</p><p><bold>Conclusion:</bold> Cardiovascular diseases occurring during pregnancy and parturition comprise a heterogeneous spectrum of conditions. Established scores aid in the identification of high-risk patients; however, in our series 14.3% women had been healthy previously.</p></abstract><kwd-group><title>Keywords</title><kwd>Cardiac disease</kwd><x>, </x><kwd>CARPREG</kwd><x>, </x><kwd>delivery</kwd><x>, </x><kwd>fetal outcome</kwd><x>, </x><kwd>pregnancy</kwd></kwd-group><counts><fig-count count="1"></fig-count><table-count count="3"></table-count><ref-count count="34"></ref-count></counts></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Spectrum of cardiovascular findings during pregnancy and parturition at a tertiary referral center</title></titleInfo><name type="personal"><namePart type="given">Waltraut M.</namePart><namePart type="family">Merz</namePart><affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mignon-Denise</namePart><namePart type="family">Keyver-Paik</namePart><affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Georg</namePart><namePart type="family">Baumgarten</namePart><affiliation>Department of Anesthesiology and Intensive Care Medicine, University Bonn Medical School, Bonn, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thorsten</namePart><namePart type="family">Lewalter</namePart><affiliation>Department of Cardiology, University Bonn Medical School, Bonn, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ulrich</namePart><namePart type="family">Gembruch</namePart><affiliation>Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Walter de Gruyter</publisher><dateIssued encoding="w3cdtf">2011-05-01</dateIssued><dateCreated encoding="w3cdtf">2011-04-19</dateCreated><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">34</extent></physicalDescription><abstract lang="en">Aim: To analyze the spectrum of cardiovascular diseases occurring during pregnancy and delivery at a tertiary referral center. Methods: All patients presenting at our institution with pre-existing or first diagnosis of cardiac disease were recruited. Cardiac and obstetric complications and maternal and neonatal outcomes were recorded. Results: Fifty-two pregnancies in 49 women, including three pregnancy terminations were analyzed. Cardiac lesions were congenital in 26 (53.1%) and acquired in nine (18.4%); six patients (12.2%) had cardiomyopathies, eight (16.3%) ar-rhythmic conditions. A total of 42 women (85.7%) had a pre-existing cardiac condition and seven (14.3%) presented with first manifestation. Overall 22 cardiac complications occurred: five in pregnancy, eight around parturition, nine during follow-up. They included >1 New York Heart Association functional class deterioration (n=5), congestive heart failure/cardiomyopathy (n=5), valve replacement (n=4), sustained arrhythmia (n=3), cerebral insult, aortic dissection, transplantation (one case each), and death (n=2). Mean gestational age at delivery was 36+6. The cesarean section rate was 77.5%; 31.6% were performed for cardiac indications. Obstetric complications happened in 23 pregnancies (46.9%). There was no perinatal loss; cardiac defects were diagnosed in 9.3% (n=5) of offspring. Conclusion: Cardiovascular diseases occurring during pregnancy and parturition comprise a heterogeneous spectrum of conditions. Established scores aid in the identification of high-risk patients; however, in our series 14.3% women had been healthy previously.</abstract><note type="author-notes">Corresponding author: Waltraut M. Merz, MD, PhD, MSc Department of Obstetrics and Prenatal Medicine University Bonn Medical School Sigmund-Freud-Str. 25 D-53105 Bonn Germany Tel.: +49-228-28715449 Fax: +49-228-28716088</note><subject><genre>Keywords</genre><topic>Cardiac disease</topic><topic>CARPREG</topic><topic>delivery</topic><topic>fetal outcome</topic><topic>pregnancy</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Perinatal Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Journal of Perinatal Medicine</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0300-5577</identifier><identifier type="eISSN">1619-3997</identifier><identifier type="PublisherID">jpme</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>39</number></detail><detail type="issue"><caption>no.</caption><number>3</number></detail><extent unit="pages"><start>251</start><end>256</end></extent></part></relatedItem><relatedItem type="reviewOf"><genre>pdf</genre><identifier type="pdf">jpm.2011.008.pdf</identifier></relatedItem><identifier type="istex">B0F9EEDB7C6002E288AF1C2D7FB9CD056F023F74</identifier><identifier type="DOI">10.1515/jpm.2011.008</identifier><identifier type="ArticleID">jpm.2011.008</identifier><identifier type="Related-article-Href">jpm.2011.008.pdf</identifier><accessCondition type="use and reproduction" contentType="copyright">©2011 by Walter de Gruyter Berlin New York</accessCondition><recordInfo><recordContentSource>De Gruyter</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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