[Maternal and perinatal outcome in patients with severe systolic dysfunction]

The objective of this study was to evaluate maternal and fetal outcome in patients with severe left ventricle systolic dysfunction followed in a tertiary-care hospital.

We retrospectively evaluated 12 pregnant women with severe systolic dysfunction, defined as a ejection fraction<40%. Follow-up data included functional class evaluation, occurrence of cardiac and obstetric events, labor data and neonatal outcome. Cardiac events were defined as new onset of arrhythmias, stroke, pulmonary thrombosis, pulmonary edema, cardiac arrest, and death.

The mean ejection fraction was 28.9+/-6.47%. Four patients were in the NYHA class III, and 8 in class I or II on presentation. Ten patients had deteriorated during pregnancy. The most common cardiac event was pulmonary edema (3 patients). Three of the four patients with class III on presentation had a good evolution during pregnancy, and the other one had preterm delivery due to worsening symptoms. There were 2 vaginal spontaneous deliveries and 10 cesarean sections. Small-for-gestational-age birthweight occurred in 10 pregnancies. There was no maternal or neonatal death.

Pregnancy in patients with severe left ventricle systolic dysfunction increases the risk of maternal complications and compromises fetal growth. It is important to follow this women in a tertiary-care hospital.