SPC365

When a mother’s heart suffers a little more than usual: a center experience of heart disease during pregnancy

Session: Posters (Sessão 1 - Écran 3) - Cardiologia em Populações Especiais 1
Speaker: Catarina Oliveira

Congress: CPC 2023
Topic: K. Cardiovascular Disease In Special Populations
Theme: 30. Cardiovascular Disease in Special Populations
Subtheme: 30.14 Cardiovascular Disease in Special Populations - Other
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Catarina Simões De Oliveira; Tatiana Guimarães; Pedro Alves da Silva; Joana Brito; Beatriz Valente Silva; Ana Margarida Martins; Beatriz Garcia; Miguel Raposo; Ana Abrantes; Catarina Gregório; Rui Plácido; Arminda Veiga; Fausto J. Pinto

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Introduction</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">: Maternal heart disease is increasingly prevalent and has emerged as one of the major causes of pregnancy-related mortality. Advanced maternal age, preexisting comorbidities namely hypertension and diabetes and the growing number of women with congenital heart disease surviving to childbearing age are some of the factors responsible for pregnancy related cardiovascular disease. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Aim</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">: to describe heart disease in pregnant women and pregnancy outcomes in an expert center for pregnancy and cardiac disease. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Methods</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">: Single-center observational study of women followed in a tertiary center by a multidisciplinary team composed of Cardiologist, Obstetrics, Anesthesiology and Specialist Nurse. Clinical data regarding cardiovascular risk factors and disease, pregnancy and postpartum period were collected and a descriptive analysis was performed.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Results</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">: </span></span></span></span><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">A total of 111 women (mean age 31<span style="color:black">&plusmn;7 years) had a cardio-obstetrics follow-up. </span>Main comorbidities were arterial hypertension (HTN) (14.4%), thyroid disease (9%), gestational diabetes (6.3%) and obesity (3.6%). </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Most women were referenced during pregnancy (87.3%; mean gestational time 22&plusmn;8 weeks), with 5.45% of pts initiating their FUP before pregnancy and 8.2% after. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Valvular heart disease was the most frequent indication for Cardiologist referral (22.5%), followed by palpitations (17.1%), previous known arrhythmia (13.5%), chronic HTN (10.8%) and cardiomyopathy (8.1%) &ndash; table 1. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Regarding cardiovascular pregnancy complications, 5.9% of pts developed preeclampsia, half of them with a previously known diagnosis of HTN and the other half with an initial diagnosis. Caesarean was the delivery route in all of these cases. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">The mean gestational period was 37<span style="color:black">&plusmn;3 weeks</span>; 19.8% of pregnancies ended with preterm labour and 8.2% presented with fetal growth restriction (FGR). Half of pregnant women with a fetus with FGR had arterial hypertension. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">In 31 cases, caesarean was the delivery route, 38.7% of them due to cardiovascular cause. Of these, 41.6% had cardiomyopathy with reduced ejection fraction, 33.3% aortic disease and 25% valvular heart disease. </span></span></span></span></p>

<p><strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Conclusion</span></span></strong><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">: Profound changes occur in the maternal circulation that have the potential to adversely impact maternal and fetal health, especially in the presence of underlying heart condition. Early and specialized multidisciplinary care in the ante, peri and postpartum is therefore essential to improve cardiovascular outcomes, mainly in more complex scenarios such as cardiomyopathy, aortic disease and valvular heart disease. </span></span></p>