第55回日本小児循環器学会総会・学術集会

講演情報

AEPC-JSPCCS Joint Symposium

AEPC-JSPCCS Joint Symposium(II-AEPCJS)
Congenital heart disease and pregnancy

2019年6月28日(金) 15:00 〜 16:00 第6会場 (小ホール)

座長:坂本 喜三郎(静岡県立こども病院)
座長:Katarina Hanseus(Lund University, Sweden)

[II-AEPCJS-03] Maternal and fetal outcomes in pregnant woman with surgically repaired congenital heart disease: retrospective Japanese multi-center study

高月 晋一1, 古谷 喜幸2, 稲井 慶2, 小林 徹3, 犬塚 亮4, 前田 潤5, 石崎 怜奈6, 山岸 敬幸6 (1.東邦大学医療センター大森病院 小児科, 2.東京女子医科大学 小児循環器科, 3.国立成育医療研究センター 臨床研究開発センター, 4.東京大学医学部附属病院 小児科, 5.東京都立小児総合医療センター 循環器科, 6.慶應義塾大学病院 小児科)

キーワード:pregnancy, congenital heart disease, premature

Background
Although dramatic success of cardiac surgery leading to increased numbers of survivors with congenital heart disease (CHD), the epidemical data has not been well-studied in Japan.
Methods and results
We retrospectively reviewed the maternal and fetal data in woman with corrected CHD from 2009 through 2014. Overall, 131 women with repaired CHD, including 70 acyanotic CHD (e.g., ventricular septal defect) and 61 cyanotic CHD (e.g., tetralogy of Fallot), were enrolled. There were 269 gestations, including 31 miscarriages (11%) and 10 elective abortions (4%). Repaired CHD with history of cyanosis group (CyCHD) had higher prevalence of caesarean delivery compared with repaired CHD without history of cyanosis group (AcyCHD) (52 (51%) vs 24 (19%), p=0.0001, respectively), whereas the prevalence of miscarriage and abortion were not statistically difference between the 2 groups. There were 228 offspring in 269 gestations (CyCHD; 102, AcyCHD; 126). The most prevalent neonatal complications were premature birth (23, 10%), which was more frequent in CyCHD than those in AcyCHD (16 (15.7%) vs 7 (5.6%), p=0.015 respectively). In addition, 5 maternal cardiac complications during delivery were noted only in cyanotic CHD group (8%), but none of women died for the complications.
Conclusions
Although most women with CHD successfully delivered after surgically repaired, there was a high prevalence of caesarean delivery in woman with repaired cyanotic CHD. In addition, history of cyanotic CHD may be a potential risk for having preterm delivery.