PMID- 29136712
OWN - NLM
STAT- MEDLINE
DCOM- 20180405
LR  - 20181202
IS  - 0578-1426 (Print)
IS  - 0578-1426 (Linking)
VI  - 56
IP  - 11
DP  - 2017 Nov 1
TI  - [Long-term outcome and prognostic factors in pregnant women with pulmonary 
      arterial hypertension associated with congenital heart disease].
PG  - 827-832
LID - 10.3760/cma.j.issn.0578-1426.2017.11.010 [doi]
AB  - Objective: To investigate the perinatal outcome, risk factors and long-term 
      outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and 
      congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who 
      were diagnosed as PAH-CHD were retrospectively analyzed in the Department of 
      Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen 
      Hospital from 2004 to 2013. The survival and treatment status were followed up. 
      Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones. 
      The incidences of deterioration in New York Heart Association (NYHA) classes (>/=2) 
      during pregnancy, respiratory failure, pulmonary hypertension crisis and 
      arrhythmia were 25.5% (28/110), 7.3% (8/110), 10.0% (11/110), 10.0% (11/110) 
      respectively. Among them, the difference of deterioration in NYHA classes (>/=2) 
      during pregnancy among the three groups was statistically significant. A total of 
      8 (7.3%) maternal deaths occurred during hospitalization, all of whom were severe 
      PAH cases. Multivariate analysis showed that pulmonary artery systolic pressure 
      was a risk factor of perioperative death (OR=1.042, P=0.005). There were 55 cases 
      (50.0%) of term delivery, and 35 cases (31.8%) of iatrogenic abortion. The 
      proportion of term delivery in the severe PAH group was significantly lower. The 
      proportion of iatrogenic abortion and small for gestational age infant (SGA) were 
      higher in severe group. The incidence of neonatal malformations was 8.0% (6/75). 
      The follow-up rate was 61.8% (63/102). Sudden death was reported in a parturient 
      a few days after discharge. The remaining 62 patients survived during follow-up, 
      while 53 patients (85.5%) were functional class (FC) Ⅰ-Ⅱ, 9 (14.5%) were FC Ⅲ-Ⅳ 
      at follow-up. The cardiac function deterioration during pregnancy was not 
      significantly correlated with long-term deterioration (P=0.767). Conclusions: 
      Perinatal mortality and the incidence of maternal and fetal adverse events were 
      high in pregnancy with PAH-CHD. Pulmonary artery systolic pressure is a major 
      risk factor for perioperative mortality in pregnant women. PAH-CHD woman had good 
      overall outcome after puerperium.
FAU - Ou, Q T
AU  - Ou QT
FAU - Lu, J K
AU  - Lu JK
FAU - Zhang, J
AU  - Zhang J
FAU - Chen, Y
AU  - Chen Y
FAU - Li, Q
AU  - Li Q
FAU - Zhang, J L
AU  - Zhang JL
AD  - Department of Surgical Intensive Care Unit, Beijing Anzhen Hospital, Capital 
      Medical University, Beijing 100029, China.
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Nei Ke Za Zhi
JT  - Zhonghua nei ke za zhi
JID - 16210490R
SB  - IM
MH  - Adult
MH  - Cesarean Section
MH  - Familial Primary Pulmonary Hypertension
MH  - Female
MH  - Gestational Age
MH  - Heart Defects, Congenital/*complications/diagnosis
MH  - Humans
MH  - Hypertension, Pulmonary/diagnosis/*etiology/therapy
MH  - Infant, Newborn
MH  - Pregnancy
MH  - Pregnancy Complications, Cardiovascular/diagnosis/*etiology
MH  - Pregnancy Outcome
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - Heart defects, congenital
OT  - Hypertension, pulmonary
OT  - Pregnancy
OT  - Pregnancy outcome
EDAT- 2017/11/15 06:00
MHDA- 2018/04/06 06:00
CRDT- 2017/11/15 06:00
PHST- 2017/11/15 06:00 [entrez]
PHST- 2017/11/15 06:00 [pubmed]
PHST- 2018/04/06 06:00 [medline]
AID - 10.3760/cma.j.issn.0578-1426.2017.11.010 [doi]
PST - ppublish
SO  - Zhonghua Nei Ke Za Zhi. 2017 Nov 1;56(11):827-832. doi: 
      10.3760/cma.j.issn.0578-1426.2017.11.010.