ISSN: 1755-5310 (Electronic)1755-5302 (Print)

Interventional Cardiology

Congenital Heart Disorders Review Articles

 Women with congenital heart disease (CHD) are not only at risk of maternal cardiovascular complications during their pregnancies, but they also have an increased risk of obstetric and offspring complications. Offspring complications such as small for gestational age and premature birth are related to maternal cardiac function, but the mechanism underlying this relationship is unknown. In this clinical study, in 209 pregnant women with CHD and 70 healthy women, we demonstrated that uteroplacental Doppler flow parameters (uterine and umbilical artery pulsatility and resistance indices) are worse in pregnant women with CHD than in healthy women and are related to maternal cardiovascular function parameters, such as right ventricular function, valvular regurgitation, heart rate, and prepregnancy need for cardiac medication. Uteroplacental flow parameters were related to offspring outcome, as is also known in the general pregnant population. Therefore, we concluded that in women with CHD, uteroplacental flow may be compromised by maternal cardiac dysfunction and that impaired uteroplacental flow may be a key factor in the high incidence of obstetric and offspring complications. Our study improves the understanding of the pathophysiology of offspring events in women with CHD and may also contribute to a better insight into the pathophysiology of offspring complications in the general population. The results of this study are of importance for counseling of women with CHD who are contemplating pregnancy and will improve risk stratification leading to more adequate monitoring of pregnancies in these women.     

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