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[Eisenmenger's syndrome and pregnancy]
Archives Des Maladies Du Coeur Et Des Vaisseaux
|May 1, 1986
Summary
Pregnancy in women with Eisenmenger syndrome carries a high mortality risk, primarily due to pulmonary embolism and microthromboses. Management requires careful consideration of cardiac status and prognostic factors.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Pulmonary Hypertension
Context:
- Eisenmenger syndrome presents significant risks during pregnancy.
- Limited data exists on pregnancy outcomes in these high-risk patients.
- Previous reports and current cases highlight severe maternal complications.
Purpose:
- To analyze the outcomes of pregnancy, abortion, and tubal ligation in women with Eisenmenger syndrome.
- To identify risk factors and causes of mortality.
- To compare findings with existing literature.
Summary:
- A review of 11 women with Eisenmenger syndrome undergoing pregnancy, abortion, or tubal ligation, alongside 42 literature cases.
- Pregnancy led to worsened dyspnea and cyanosis in 72.4%, pulmonary embolism in 7 cases, and toxemia in 26%.
- Overall mortality was 36%, with micro pulmonary thromboses being the leading cause of death, often occurring postpartum.
Impact:
- Identified key prognostic factors including decreased arterial oxygen saturation and toxemia.
- Elucidated two primary mechanisms worsening cardiac status: increased right-to-left shunt due to pulmonary resistance changes and decreased systemic vascular resistance.
- Highlights the critical need for careful management and risk assessment in pregnant women with Eisenmenger syndrome.