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[Analysis of maternal deaths with cardiovascular diseases in Shanghai obstetric heart disease intensive care unit within twenty-six years].
- Source :
-
Zhonghua fu chan ke za zhi [Zhonghua Fu Chan Ke Za Zhi] 2019 Dec 25; Vol. 54 (12), pp. 826-832. - Publication Year :
- 2019
-
Abstract
- Objective: To analyze risk factors, cardiovascular complications, time of death, gestational age of delivery and offspring outcomes in the maternal deaths with cardiovascular diseases (CVD). Methods: Totally 4 112 cases of pregnant women with CVD in Shanghai obstetric heart disease intensive care unit within 26 years (from January 1993 to December 2018) were collected, and 20 maternal deaths within these cases were analyzed retrospectively. Results: (1) Among the 20 deaths, structural heart diseases accounted for 90% (18/20), pregnancy induced heart diseases was 10% (2/20) while there was no dysfunctional heart disease. The mortality of pregnant women with CVD was 0.486% (20/4 112). (2) The following risk factors were common in these women, getting pregnant without counselling (95%, 19/20) , New York Heart Association classⅢ or Ⅳcardiac function (70%, 14/20), complicated with pulmonary hypertension (75%, 15/20) and prior heart events (60%, 12/20). And 85% (17/20) deaths occurred in puerperium, 15% (3/20) occurred before labor,while no death occurred during labor. And 65% (13/20) deaths died due to heart failure, 20% (4/20) deaths were due to pulmonary hypertension crisis, 5% (1/20) died on sudden cardiac arrest, rupture of aortic dissection and sudden death, respectively. Conclusions: Women with CVD should get pregnant after strict evaluation. Pulmonary hypertension is one of the most severe contraindications to pregnancy, especially in patients with moderate to severe pulmonary hypertension. The puerperium period is a critical period that threatens the safety of these patients. Since heart failure is the most common cause of death, it is necessary to prevent and treat heart failure and to monitor heart function dynamically, especially in those with structural abnormal heart diseases. Moreover, it is also of importance to standardize antenatal care and to identify the severity of heart diseases in time.
- Subjects :
- Adult
Cause of Death
China epidemiology
Female
Humans
Maternal Health Services organization & administration
Pregnancy
Pregnancy Complications, Cardiovascular diagnosis
Pregnancy Complications, Cardiovascular mortality
Pregnancy Outcome
Retrospective Studies
Risk Factors
Cardiovascular Diseases mortality
Intensive Care Units statistics & numerical data
Maternal Death
Maternal Mortality trends
Pregnancy Complications, Cardiovascular etiology
Subjects
Details
- Language :
- Chinese
- ISSN :
- 0529-567X
- Volume :
- 54
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Zhonghua fu chan ke za zhi
- Publication Type :
- Academic Journal
- Accession number :
- 31874472
- Full Text :
- https://doi.org/10.3760/cma.j.issn.0529-567x.2019.12.006