Background: Pregnant women with cardiac diseases present a challenge
for both obstetricians and cardiologists, especially in developing countries with
limited medical resources. This study aimed to determine the clinical
features and pregnancy outcomes of pregnant women with cardiac diseases in
Vietnam. Methods: In this patient registry descriptive study,
pregnant women with heart disease, admitted to the Department of Obstetrics and
Gynecology, Hue Central Hospital, Vietnam, between January 2017 and December
2020, were recruited. Pregnant women were classified into the high-risk group if
at least one of the following risk clinical features was present: (1) left
ventricular ejection fraction (EF) 50%, and (2) New York Heart Association—NYHA
classification—NYHA class II or cyanosis, or (3) left heart
obstruction; patients without these risk conditions were categorized into the
low-risk group. Results: A total of 134 pregnant women
were included, with a mean age of 27.8 4.8 years old; 32.1% had mitral
valve disease, 23.9% had rhythm disorders, 15.7% had congenital heart disease,
9.0% had aortic valve disease, and 3.0% had both mitral and aortic valve
disease. Maternal complications during pregnancy included heart failure (37.3%),
irregular heart rhythm (35.8%), thrombosis (0.7%), and valve blockage (0.7%).
A total of 66.7% of the high-risk patients underwent cesarean section, 22.2%
with therapeutic abortion, and 11.1% with miscarriage. The frequency of
gestational age over 35 weeks in the high-risk and low-risk groups were 55.6%
and 92.8%, respectively (Odds ratios = 0.097, 95% Confidence Interval:
0.02–0.43, p 0.05). The mean birth weight in the high-risk and
low-risk groups was 2800.0 438.2 and 2988.4 390.6 g, p 0.05, respectively. Conclusions: Cardiovascular disorders in
pregnant women have a higher rate of complications that affect mother and fetus.
Risk stratification plays an important role in management during pregnancy and is
essential to improve the outcomes in developing countries with limited medical
resources.
