Karyono, Jatno
April 2010
Folia Medica Indonesiana;abr2010, Vol. 46 Issue 2, p139
Academic Journal
Pregnancy in heart disease is at high risk for cardiac events. Heart failure (NYHA III-IV), ejection fraction (EF)<40%, cyanocis and left ventricle obstruction (MVA< 2 cm2 or AVA <1,5 cm2) are parameters that still use in predicting cardic events in pregnancy. But in clinical experience, pregnancy with MVA 1.5-2 cm2 still can have the pregnancy without cardiac events. These parameters haven't included congenital heart disease (CHD) and hypertension with preserved EF and cyanosis hadn't still occurred has the potency the occurance of cardiac events. To date, no exact parameters associate with severity of CHD are high risk for occurance cardiac events in pregnancy. The objective was to prove MVA <1.5cm2, CHD with PASP 60 > mmHg, and chronic hypertension with left ventricle hypertrophy as risk of occurance for cardiac events in pregnancy. Ninety two pregnant women with mitral stenosis, MVA < 1.5cm2, CHD with PASP >60 mmHg and chronic hypertension with left venricle hypertrophy based on registry from 2002 to 2007, restropectively through medical record and classified into groups based on occurance of cardiac events. Ninety two pregnant women in 5.5 year period fulfilled inclusion criterias. 46.75% had cardiac events. There are significant association between MVA <1.5cm2 (CI 1.61-78.56, p=0.01), CHD with PASP > 60 mmHg (CI 1.97-19.04, p=0.01) and chronic hypertension with left ventricle hypertrophy (CI 1.16-52.35, p=0.001) with the occurance of cardiac events. In conclusion, pregnancy with severe MS, CHD with pulmonary hypertension moderate-severe and chronic hypertension with left ventricle hypertrophy are at risk of cardiac events along the pregnancy.


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