Author + information
- Amitoj Singh,
- Sahil Agrawal,
- Kanika Samra,
- Sajeev Saluja,
- Uzma Tariq,
- Lohit Garg,
- Rasha Aurshiya,
- Mark Fegley,
- Yugandhar Manda,
- Sudip Nanda and
- Jamshid Shirani
Background: Childbirth poses increased risk of death and adverse cardiovascular outcomes in women with hypertrophic cardiomyopathy (HCM). Data is, however, scarce and limited to small number of patients reported from large tertiary care centers. We aimed to examine the maternal cardiovascular and obstetric outcomes of childbirth in women with HCM in the US.
Methods: Study population existed of 422 mothers with HCM (age 29±6 years, 53% Caucasians) admitted to a hospital for childbirth from 2003-2011 according to Nationwide Inpatient Sample database.
Results: Mode of delivery was Cesarean section (CS) in 58% and mean length of stay was 5±9 days. No maternal mortality was reported and serious cardiovascular complications were uncommon including cardiac arrest [n=5 (1.1%)], cardiogenic shock [n=5 (1.1%)], and ventricular tachycardia [n=20 (4.6%)]. Cardiopulmonary resuscitation, mechanical circulatory support (other than balloon counterpulsation) and temporary venous pacemaker were required each in 5 women (1.1%) while 14 (3.4%) needed mechanical ventilation. Acute respiratory distress syndrome, deep veins thrombosis and acute renal failure was reported in 5 women each (1.1%). Obstetric complications included abruption placenta [n=28 (7%)], preterm labor [n=89 (21%)], premature rupture of membranes [n=20 (5%)], pre-eclampsia/eclampsia [n=19 (4.5%)] and gestational hypertension [n=10 (2.3%)]. Post partum hemorrhage occurred in 3.3% and maternal blood transfusion was needed in 5.8%. Labor was obstructed in 2.3% and 32% of vaginal deliveries required instrument assistance. There was no fetal mortality. However, fetal distress, abnormal fetal heart rate and fetal growth retardation occurred in 15%, 14% and 3.6%, respectively. Overall, 23% and 40% of parturient suffered at least one adverse cardiovascular or obstetric complication, respectively.
Conclusions: Despite promotion of vaginal delivery as preferred mode, most deliveries in HCM are through CS. Maternal and fetal mortality remains remarkably low while maternal cardiovascular and obstetric complications occur in a sizable proportion.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in HCM, PPCM and Other Cardiomyopathies
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1201-274
- 2017 American College of Cardiology Foundation