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Research: ZHOU and COLLEAGUES,
Listed in Issue 215
Abstract
ZHOU and COLLEAGUES, Department of SICU, Beijing Institute of Heart, Lung and Blood Vessel Disease, Capital Medical University Affiliated Beijing Anzhen Hospital, Beijing 100029, China. jinglanzhang2006@yahoo.com.cn studied the risk factors for postpartum cardiac events in pregnant women with heart
Background
To investigate the risk factors for postpartum cardiac events in pregnant women with heart diseases and to provide prenatal counseling for them.
Methodology
A retrospective analysis was made in cases of pregnant women with heart diseases admitted to the surgical intensive care unit (SICU) of Anzhen Hospital from May 2004 to May 2012. Data were used to identify univariate and multivariate predictors for postpartum cardiac events.
Results
A total of 190 patients ( > 20 weeks gestation) were enrolled in the study with 134 (70.5%) of congenital heart disease, 30(15.8%) of rheumatic heart disease, 10 (5.3%) of cardiomyopathy, 2 (1.1%) of peripartum cardiomyopathy and 14 (7.4%) of hypertensive heart disease. Postpartum cardiac events were observed in 42 cases with the incidence of 22.1%. A total of 7 cases resulted in death with the mortality rate of 3.7%. Among them, 5 cases were dead of circulatory collapse and pulmonary hypertensive crisis postpartum, while the other 2 cases with secondary pulmonary infection were died of respiratory and circulatory collapse. The baseline parameters of New York Heart Academy(NYHA)>1, left ventricular ejection fraction(LVEF)<50%, use of cardiac drugs and pulmonary artery hypertension (PAH)>80 mm Hg(1 mm Hg = 0.133 kPa) were the independent predictors for postpartum cardiac events by univariate and multivariate logistic regression analysis.
Conclusion
The incidence of postpartum cardiac events is high in pregnant women with heart diseases. Pulmonary artery hypertension and heart failure are the main causes of death.
References
Zhou XR, Lu JK, Chen Y, Li Q, Ye Q, Sun JP and Zhang JL. disease]. [An analysis of risk factors for postpartum cardiac events in pregnant women with heart disease [Chinese] Chung-Hua Nei Ko Tsa Chih Chinese Journal of Internal Medicine. 52(11):966-9. Nov 2013.
