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Pregnancy in women with hypertrophic cardiomyopathy

Arend F L Schinkel1

  • 1From the Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.

Cardiology in Review
|August 6, 2014
PubMed

Insights

Pregnancy in women with hypertrophic cardiomyopathy (HCM) has low maternal mortality (0.5%). Most pregnancies are uneventful, but risks like premature birth (26%) are increased for both mother and fetus.

Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Genetics

Background:

  • Pregnancy significantly stresses the cardiovascular system.
  • Pre-existing heart conditions, like hypertrophic cardiomyopathy (HCM), increase risks during pregnancy.
  • Maternal mortality and adverse fetal outcomes are concerns in high-risk pregnancies.

Purpose of the Study:

  • To review maternal and fetal outcomes of pregnancy in women with hypertrophic cardiomyopathy (HCM).
  • To identify complications associated with pregnancy in HCM patients.
  • To provide an evidence-based overview for managing these pregnancies.

Main Methods:

  • Systematic literature review of MEDLINE database.
  • Inclusion of cohort design studies reporting pregnancy outcomes in HCM.
  • Pooled analysis of data from 11 studies (9 cohorts, 237 women, 408 pregnancies).

Main Results:

  • Most pregnancies in women with HCM were uneventful.
  • Maternal mortality rate was 0.5%, primarily in high-risk individuals.
  • Complications or symptom worsening occurred in 29% of patients.
  • Fetal risks included spontaneous abortion (15%), therapeutic abortion (5%), stillbirth (2%), and premature birth (26%).

Conclusions:

  • Pregnancy in women with HCM carries low maternal mortality, concentrated in high-risk profiles.
  • Fetal mortality rates are comparable to the general population.
  • Increased risk of premature birth is a significant concern in HCM pregnancies.

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