Fetal outcomes in pregnant women undergoing cardiac surgery during pregnancy: an analysis of 20 cases
10.3760/cma.j.cn131073.20231031.00406
- VernacularTitle:妊娠期行心脏手术孕妇的胎儿结局：20例病例分析
- Author:
He JING
1
;
Jiakai LU
;
Weiping CHENG
;
Min WEI
;
Sheng WANG
Author Information
1. 首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉中心，北京 100029
- Keywords:
Pregnancy;
Cardiac surgical procedures;
Fetus;
Pregnancy outcome
- From:
Chinese Journal of Anesthesiology
2024;44(4):412-417
- CountryChina
- Language:Chinese
-
Abstract:
The medical records from 20 pregnant women with pregnancy preservation who underwent only cardiac surgery in our hospital from January 2012 to December 2022 were retrospectively analyzed. The patients were divided into 2 groups according to the fetal outcome: fetal survival group and fetal loss group. Eleven patients were included in fetal survival group and 9 patients in fetal loss group. The overall fetal mortality rate was 45%. In fetal loss group, 2 cases died during operation, and the other 7 cases died at 26 (29) days after operation. The valvular disease and infective endocarditis were the most common heart diseases diagnosed in fetal survival group, while type A aortic dissection in fetal loss group. There were 2 cases and 6 cases with pulmonary hypertension, 2 cases and 3 cases with a history of cardiac surgery, and 3 cases and 5 cases underwent emergency surgery in fetal survival group and in fetal loss group, respectively. Four pregnant women underwent deep hypothermic circulatory arrest in fetal loss group. One patient with type A aortic dissection died 15 days after cardiac surgery, with an overall maternal mortality rate of 5% in fetal loss group. The incidence of adverse events after maternal cardiac surgery was 25%, all of which occurred in fetal loss group. In conclusion, the adverse fetal outcomes may be related to type A aortic dissection, pulmonary hypertension, recardiac surgery, emergency surgery, deep hypothermic circulatory arrest, adverse events after cardiac surgery, and long-term related factors after surgery in pregnant women with pregnancy preservation undergoing cardiac surgery alone.
