Prospective validation and assessment of cardiovascular and offspring risk models for pregnant women with congenital heart disease.

Objectives: Adequate prepregnancy prediction of maternal cardiovascular and offspring risk is important for counselling and management of pregnancy in women with congenital heart disease (CHD). Therefore we performed a study to identify the optimal assessment strategy for estimating the risk of pregnancy in women with CHD.

Methods: In this prospective study, we determined the outcomes of 213 pregnancies in 203 women with CHD.

Uteroplacental blood flow, cardiac function, and pregnancy outcome in women with congenital heart disease.

Background: Pregnant women with congenital heart disease (CHD) are susceptible to cardiovascular, obstetric, and offspring complications. In women with CHD, cardiac dysfunction may compromise uteroplacental flow and contribute to the increased incidence of obstetric and offspring events.

Methods And Results: We performed a prospective multicenter cohort study of pregnant women with CHD and healthy pregnant women.

Pregnancy in women with corrected tetralogy of Fallot: occurrence and predictors of adverse events.

Background: In women with corrected tetralogy of Fallot (ToF), pregnancy is associated with maternal cardiac, obstetric, and offspring complications. Our aim is to investigate the magnitude and determinants of pregnancy outcome in women with corrected ToF.

Methods: In this retrospective international multicenter study using 2 congenital heart disease registries, 204 women with corrected ToF were identified.

Associations between cardiovascular parameters and uteroplacental Doppler (blood) flow patterns during pregnancy in women with congenital heart disease: Rationale and design of the Zwangerschap bij Aangeboren Hartafwijking (ZAHARA) II study.

Background: Previous research has shown that women with congenital heart disease (CHD) are more susceptible to cardiovascular, obstetric, and offspring events. The causative pathophysiologic mechanisms are incompletely understood. Inadequate uteroplacental circulation is an important denominator in adverse obstetric events and offspring outcome.

Predictors of pregnancy complications in women with congenital heart disease.

Aims: Data regarding pregnancy outcome in women with congenital heart disease (CHD) are limited.

Methods And Results: In 1802 women with CHD, 1302 completed pregnancies were observed. Independent predictors of cardiac, obstetric, and neonatal complications were calculated using logistic regression.

Menstrual cycle and its disorders in women with congenital heart disease.

Objectives: To investigate the age at menarche, the prevalence of menstrual cycle (interval) disorders, and determinants in women with congenital heart disease (CHD).

Design: Using two CHD registries, 1802 (82%) of the 2196 women with CHD contacted (aged 18-58 years) provided written informed consent. After exclusion of patients with genetic disorders known to be associated with menstrual cycle disorders, 1593 eligible patients remained.

Three live-birth pregnancies in a woman with Williams syndrome.

Objective: Maternal Williams syndrome with their associated (cardiac) malformations is rarely encountered during pregnancy.

Methods: We report on a patient with Williams syndrome who has had 3 live-birth pregnancies.

Results: Several noncardiac, mainly fetal, complications need to be anticipated: premature labor, intrauterine growth restriction with subsequent small-for-gestational-age offspring, and recurrence of congenital heart disease or similar syndromes.

Severe pregnancy-induced deterioration of truncal valve regurgitation in an adolescent patient with repaired truncus arteriosus.

Truncus arteriosus, a rare and complex congenital heart disease, is hallmarked by a single great vessel (truncus) that arises over a large ventricular septal defect and provides both the pulmonary and systemic circulation. Pregnancy reports after repair for truncus arteriosus are scarce. Therefore, the maternal and offspring outcomes are unknown.

Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease.

Background And Aim Of The Study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve replacement is limited.

Methods: Using a nationwide Dutch registry (CONCOR) and a local Belgian tertiary care center database, 17 women (age range: 18 to 45 years) with pulmonary autograft valve replacement were enrolled into the study.

Smoking and its effects on mortality in adults with congenital heart disease.

Aims: To describe smoking habits in adults with congenital heart disease (ACHD) and to assess the relationship between smoking exposure and cardiovascular mortality.

Methods: Data on smoking history and cardiovascular mortality were extracted from the Euro Heart Survey on adult congenital heart disease - a retrospective cohort study, that included patients diagnosed with 1 of 8 subgroups of ACHD (Atrial Septal Defects, Ventricular Septal Defects, Marfan Syndrome, Aortic Coarctation, Tetralogy of Fallot (ToF), Transposition of the Great Arteries (TGA), Fontan circulation, and Cyanotic disease).

Results: Complete data of 3375 ACHD patients (median age 28 years) were available for analysis.

Outcome of pregnancy in women with congenital heart disease: a literature review.

A search of peer-reviewed literature was conducted to identify reports that provide data on complications associated with pregnancy in women with structural congenital heart disease (CHD). This review describes the outcome of 2,491 pregnancies, including 377 miscarriages (15%) and 114 elective abortions (5%). Important cardiac complications were seen in 11% of the pregnancies.

Risk of complications during pregnancy in women with congenital aortic stenosis.

Background: Pregnancy in women with congenital aortic stenosis (AS) is associated with increased cardiac complications. Data on non-cardiac complications are limited, and this information is crucial for prenatal counselling and perinatal care. The aim of this study was to present the maternal and perinatal outcome of pregnancy in women with congenital AS.

Outcome of implantable cardioverter defibrillators in adults with congenital heart disease: a multi-centre study.

Aims: To investigate outcome and complications of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) and to identify predictors of (in-) appropriate shocks.

Methods And Results: Sixty-four CHD patients >/= 18 years at first ICD implantation [63% tetralogy of Fallot (TOF) and age at implantation 37 +/- 13 years] were identified using the Dutch adult CHD registry and a Belgian tertiary care centre database. Median follow-up duration was 3.

Pregnancy after biventricular repair for pulmonary atresia with ventricular septal defect.

Information on pregnancy and delivery in women with biventricular repair for isolated noncomplex pulmonary atresia with a ventricular septal defect (PAVSD) is limited. Using a nationwide congenital heart disease registry (CONgenital CORvitia [CONCOR]), 9 women with biventricular repair for PAVSD (aged 21 to 38 years) were identified. Ten pregnancies were observed in 5 different women with PAVSD, including 3 spontaneous miscarriages.

Fertility, pregnancy, and delivery after biventricular repair for pulmonary atresia with an intact ventricular septum.

The objective of the present study to investigate fertility, pregnancy, and delivery in women with biventricular repair for pulmonary atresia with an intact ventricular septum (PAIVS). Using a nationwide registry (CONCOR), 37 patients with pulmonary atresia were identified, 6 of whom (aged 21 to 34 years) had biventricular repair for PAIVS. Three PAIVS patients had a total of 5 pregnancies, including 1 abortion and 1 ectopic pregnancy.

Obstetric complications in Marfan syndrome.

Objective: To investigate the obstetric maternal and neonatal outcome of pregnancy in women with Marfan syndrome.

Methods: Retrospective observational multi-center study based on congenital heart disease registry.

Results: Sixty-three of the 122 enrolled women with Marfan syndrome had been pregnant 142 times (including 111 pregnancies>20 weeks, 28 (20%) miscarriages and 3 elective abortions).

Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries.

Aims: To investigate magnitude and determinants of risks during pregnancy in women with Mustard or Senning repair for complete transposition of the great arteries (TGA).

Methods And Results: Using a nationwide registry (CONCOR), 70 women with Senning (23%) or Mustard (77%) repair for TGA were enrolled. A total of 28 patients had 69 pregnancies (two twins), including 17 spontaneous miscarriages and three elective abortions.

Cardiac complications relating to pregnancy and recurrence of disease in the offspring of women with atrioventricular septal defects.

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.