PMID- 16107486
OWN - NLM
STAT- MEDLINE
DCOM- 20060524
LR  - 20061115
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 26
IP  - 23
DP  - 2005 Dec
TI  - Cardiac complications relating to pregnancy and recurrence of disease in the 
      offspring of women with atrioventricular septal defects.
PG  - 2581-7
AB  - AIMS: In most pregnancy reports, atrioventricular septal defects (AVSD) are not 
      differentiated from more simple septal defects, thus underestimating the risks of 
      pregnancy. To investigate the magnitude and determinants of risk during pregnancy 
      in female patients with balanced AVSD. METHODS AND RESULTS: Using a nation-wide 
      registry (CONCOR), 79 female patients with balanced/isolated AVSD were 
      identified. A total of 29 patients had 62 pregnancies, including 12 miscarriages 
      (19%) and two elective abortions. Detailed recordings of each completed (>20 
      weeks gestation) pregnancy (n=48, 26 women) were obtained. Cardiovascular events 
      complicated almost 40% of the completed pregnancies. In particular, post-partum 
      persistence of pregnancy-related New York Heart Association (NYHA) class 
      deterioration [23% mainly patients with residual atrial septal defects (ASD)] and 
      deterioration of pre-existing left AV-valvular regurgitation (17%) were 
      frequently recorded. Additional cardiac complications were arrhythmias (19%) and 
      symptomatic heart failure (2%). Congenital heart disease (CHD) recurred in six 
      children (12%): AVSD (n=4, three with left-sided hypoplasia), patent ductus 
      arteriosus (n=1), and ASD (n=1). Three children died including two children with 
      left-sided hypoplasia. CONCLUSION: Pregnancy is not always well tolerated in 
      women with AVSD, predominantly due to NYHA class deterioration and worsening of 
      pre-existing AV-valvular regurgitation. Offspring mortality is high (6.3%), 
      primarily due to recurrence of complex CHD.
FAU - Drenthen, Willem
AU  - Drenthen W
AD  - Department of Cardiology, University Medical Centre Groningen, PO Box 30.001, 
      9700 RB Groningen, The Netherlands. w.drenthen@thorax.umcg.nl
FAU - Pieper, Petronella G
AU  - Pieper PG
FAU - van der Tuuk, Karin
AU  - van der Tuuk K
FAU - Roos-Hesselink, Jolien W
AU  - Roos-Hesselink JW
FAU - Voors, Adriaan A
AU  - Voors AA
FAU - Mostert, Bianca
AU  - Mostert B
FAU - Mulder, Barbara J M
AU  - Mulder BJ
FAU - Moons, Philip
AU  - Moons P
FAU - Ebels, Tjark
AU  - Ebels T
FAU - van Veldhuisen, Dirk J
AU  - van Veldhuisen DJ
CN  - Zahara Investigators
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20050817
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
MH  - Adult
MH  - Coronary Disease/*etiology
MH  - Female
MH  - *Heart Septal Defects
MH  - Humans
MH  - Hypertension, Pregnancy-Induced/etiology
MH  - Infant, Newborn
MH  - Infertility, Female/*etiology
MH  - Pedigree
MH  - Pre-Eclampsia/etiology
MH  - Pregnancy
MH  - *Pregnancy Complications, Cardiovascular
MH  - *Pregnancy Outcome
MH  - Risk Factors
EDAT- 2005/08/19 09:00
MHDA- 2006/05/25 09:00
CRDT- 2005/08/19 09:00
PHST- 2005/08/19 09:00 [pubmed]
PHST- 2006/05/25 09:00 [medline]
PHST- 2005/08/19 09:00 [entrez]
AID - ehi439 [pii]
AID - 10.1093/eurheartj/ehi439 [doi]
PST - ppublish
SO  - Eur Heart J. 2005 Dec;26(23):2581-7. doi: 10.1093/eurheartj/ehi439. Epub 2005 Aug 
      17.