PMID- 23860210
OWN - NLM
STAT- MEDLINE
DCOM- 20140106
LR  - 20220331
IS  - 1097-6868 (Electronic)
IS  - 0002-9378 (Linking)
VI  - 209
IP  - 5
DP  - 2013 Nov
TI  - Risk factors for maternal and fetal outcome in pregnancy complicated by Ebstein 
      anomaly.
PG  - 452.e1-6
LID - S0002-9378(13)00714-X [pii]
LID - 10.1016/j.ajog.2013.07.005 [doi]
AB  - OBJECTIVE: The goal of the study was to examine risks in pregnancy in patients 
      with Ebstein anomaly. STUDY DESIGN: Data were examined retrospectively for 13 
      patients (27 pregnancies, 21 live births) with Ebstein anomaly during pregnancy 
      who were treated at our institution from 1985 to 2011. The associated anomalies 
      in these patients were atrial septal defect (ASD) (n = 4) and the 
      Wolff-Parkinson-White syndrome (n = 6). RESULTS: Before pregnancy, 2 patients 
      underwent ASD closure and 1 received tricuspid valve replacement (TVR). In all 
      patients, the cardiothoracic ratio increased from 55.1 at conception to 57.0 
      during pregnancy and 58.0 postpartum (P < .05). Cesarean sections were performed 
      in 3 cases: 1 with ventricular tachycardia and orthopnea (New York Heart 
      Association [NYHA] III) preterm; at full term, and the third in a patient with a 
      mechanical tricuspid valve who developed maternal cerebellum hemorrhage at 27 
      weeks. The baby died of prematurity in the third case. In all other cases (20 of 
      21), neonatal prognoses were good without congenital heart diseases. There were 6 
      spontaneous abortions. Recurrent paroxysmal supraventricular tachycardia occurred 
      during pregnancy in 2 cases and was treated with adenosine triphosphate or 
      verapamil. In 17 pregnancies, NYHA remained in class I and all had full-term 
      vaginal delivery. CONCLUSION: Maternal and fetal outcomes are good in patients 
      with Ebstein anomaly and NYHA class I. However, pregnancy in Ebstein anomaly can 
      be complicated with tachyarrhythmia or cardiac failure. In post-TVR cases, 
      meticulous care is required for these complications during pregnancy and 
      delivery.
CI  - Copyright (c) 2013 Mosby, Inc. All rights reserved.
FAU - Katsuragi, Shinji
AU  - Katsuragi S
AD  - Department of Perinatology and Gynecology, National Cerebral and Cardiovascular 
      Center, Osaka, Japan. Electronic address: skatsura12@yahoo.co.jp.
FAU - Kamiya, Chizuko
AU  - Kamiya C
FAU - Yamanaka, Kaoru
AU  - Yamanaka K
FAU - Neki, Reiko
AU  - Neki R
FAU - Miyoshi, Takekazu
AU  - Miyoshi T
FAU - Iwanaga, Naoko
AU  - Iwanaga N
FAU - Horiuchi, Chinami
AU  - Horiuchi C
FAU - Tanaka, Hiroaki
AU  - Tanaka H
FAU - Yoshimatsu, Jun
AU  - Yoshimatsu J
FAU - Niwa, Koichiro
AU  - Niwa K
FAU - Ikeda, Tomoaki
AU  - Ikeda T
LA  - eng
PT  - Journal Article
DEP - 20130713
PL  - United States
TA  - Am J Obstet Gynecol
JT  - American journal of obstetrics and gynecology
JID - 0370476
SB  - IM
MH  - Abortion, Spontaneous
MH  - Adult
MH  - Cesarean Section
MH  - Cohort Studies
MH  - Ebstein Anomaly/*complications
MH  - Female
MH  - Heart Septal Defects, Atrial/*complications/surgery
MH  - Humans
MH  - Pregnancy
MH  - *Pregnancy Complications, Cardiovascular
MH  - *Pregnancy Outcome
MH  - Premature Birth
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Tricuspid Valve/surgery
MH  - Wolff-Parkinson-White Syndrome/*complications/therapy
OTO - NOTNLM
OT  - Ebstein anomaly
OT  - New York Heart Association
OT  - arrhythmia
OT  - cardiac function
OT  - pregnancy
EDAT- 2013/07/19 06:00
MHDA- 2014/01/07 06:00
CRDT- 2013/07/18 06:00
PHST- 2013/04/12 00:00 [received]
PHST- 2013/06/02 00:00 [revised]
PHST- 2013/07/01 00:00 [accepted]
PHST- 2013/07/18 06:00 [entrez]
PHST- 2013/07/19 06:00 [pubmed]
PHST- 2014/01/07 06:00 [medline]
AID - S0002-9378(13)00714-X [pii]
AID - 10.1016/j.ajog.2013.07.005 [doi]
PST - ppublish
SO  - Am J Obstet Gynecol. 2013 Nov;209(5):452.e1-6. doi: 10.1016/j.ajog.2013.07.005. 
      Epub 2013 Jul 13.