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Pregnancy after heart surgery--challenges.

PURPOSE
Advances in cardiac surgery significantly improve life expectancy and quality of life of patients with congenital or acquired heart disease.


MATERIALS AND METHODS
The present study included 146 pregnant women who had antenatal care and gave birth at the Institute of Gynecology and Obstetrics in an interval of ten years from 1994-2004. Patients were divided in four groups according to the type of heart surgery. Group I included four patients with surgically corrected coarctation of the aorta. Group II included 27 patients with correction of the ostial stenosis. Group III had 68 patients with correction of congenital heart diseases, and group IV had 47 patients with artificial heart valves.


RESULTS
There was 4% of heart failure after delivery. The incidence of hemorrhagic complications during pregnancy was 2.7% and 4.1% after delivery. The incidence of thromboembolic complications after delivery was 6%. Four newborns died; one of hydrocephalus and three of hypoxic ischemic encephalopathy. Two patients died.


CONCLUSION
Patients with artificial heart valves need an enhanced level of medical care during pregnancy and labor.