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Characterization of cardiac arrhythmias and maternal–fetal outcomes in pregnant women: A prospective cohort study

التفاصيل البيبلوغرافية
العنوان: Characterization of cardiac arrhythmias and maternal–fetal outcomes in pregnant women: A prospective cohort study
المؤلفون: Edison Muñoz-Ortiz, Andrés Felipe Miranda-Arboleda, Yesid Alberto Saavedra-González, Jairo Alfonso Gándara-Ricardo, Jesús Velásquez-Penagos, Natalia Giraldo-Ardila, Magnolia Zapata-Montoya, Erica Holguín-Gonzalez, Francisco Villegas-García, Juan Manuel Senior-Sanchez
المصدر: Revista Portuguesa de Cardiologia, Vol 43, Iss 2, Pp 67-74 (2024)
بيانات النشر: Elsevier, 2024.
سنة النشر: 2024
المجموعة: LCC:Diseases of the circulatory (Cardiovascular) system
مصطلحات موضوعية: Arritmias, Gravidez, Desfechos materno-fetais, Contrações ventriculares prematuras, Taquicardia supraventricular, Cardio-obstetrícia, Diseases of the circulatory (Cardiovascular) system, RC666-701
الوصف: Introduction and Objectives: Cardiovascular disease is a common cause of morbidity and mortality in pregnant women. Arrhythmias are common complications during pregnancy; however, the data are limited. Our goal was to characterize the epidemiology, clinical presentation, and impact of cardiac arrhythmias on maternal–fetal outcomes. Methods: A prospective cohort study from the Colombian Registry of Pregnancy and Cardiovascular Disease was carried out from 2016 to 2019. All patients with tachyarrhythmia or bradyarrhythmia and a minimum follow-up of six months after delivery were included. The primary outcome was a composite of cardiac events defined as pulmonary edema, symptomatic sustained arrhythmia requiring specific therapy, stroke, cardiac arrest, or maternal death. Secondary outcomes were other cardiac, neonatal, and obstetric events. Results: Arrhythmias were the most common cause of referral to our dedicated cardio-obstetric clinic. A total of 92 patients were included, mean age 27 ± 6 years; 8.7% had previous structural heart disease, and cardiology consultation was delayed in 79.4%. The most common arrhythmias were premature ventricular contractions (33%) and paroxysmal reentrant supraventricular tachycardias (15%); 11 patients (12%) had cardiac implantable electronic devices. Cardiac events occurred in 18.4% of patients, obstetric events occurred in 6.5%, and one caesarean was indicated in the context of symptomatic severe mitral stenosis. Adverse neonatal outcomes were observed in 24.3% of newborns. Conclusions: Arrhythmias were the most common cause of referral to a dedicated cardio-obstetric clinic; most had a benign course. Adverse maternal cardiovascular outcomes were significant and there was a high rate of obstetric and neonatal adverse events, underlining the importance of multidisciplinary care. Resumo: Introdução e objetivos: As doenças cardiovasculares são uma causa comum de morbidade e mortalidade em mulheres grávidas. As arritmias são complicações comuns durante a gravidez; no entanto, há dados limitados. O nosso objetivo foi caracterizar a epidemiologia, a apresentação clínica e os desfechos das arritmias cardíacas nos desfechos materno-fetais. Métodos: Coorte prospetiva do Registo de Gravidez e Doenças Cardiovasculares (REMEC) foi realizada entre 2016 e 2019. Foram incluídas todas as pacientes com taquiarritmia ou bradiarritmia e seguimento mínimo de seis meses após o parto. O desfecho primário foi um composto de eventos cardíacos definidos como edema pulmonar, arritmia sustentada sintomática que requer terapia específica, acidente vascular cerebral, parada cardíaca ou morte materna; os desfechos secundários incluíram outros eventos cardíacos, neonatais e obstétricos. Resultados: Foram incluídas 92 pacientes, a média de idade foi de 27 (± 6) anos, 8,7% apresentavam cardiopatia estrutural prévia e 79,4% tiveram atraso na consulta de cardiologia. As arritmias mais comuns foram contrações ventriculares prematuras (33%) e taquicardias supraventriculares reentrantes paroxísticas (15%); 11 pacientes (12%). Tinham dispositivos cardíacos eletrónicos implantáveis. O eventos cardíacos estiveram presente em 18,4%. Intercorrências obstétricas ocorreram em 6,5% das pacientes, sendo indicada uma cesariana no contexto de estenose mitral grave sintomática. Desfechos neonatais adversos estiveram presentes em 24,3% dos recém-nascidos. Conclusões: As arritmias são a causa mais comum de encaminhamento para uma clínica cardio-obstétrica dedicada; a maioria delas tem um curso benigno. Desfechos cardiovasculares maternos adversos foram significativos e uma taxa importante de eventos adversos obstétricos e neonatais, destacando a importância do cuidado multidisciplinar.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
Portuguese
تدمد: 0870-2551
Relation: http://www.sciencedirect.com/science/article/pii/S0870255123004572; https://doaj.org/toc/0870-2551
DOI: 10.1016/j.repc.2023.08.003
URL الوصول: https://doaj.org/article/4e32b2d2a4514824bd16c7a6363853e1
رقم الأكسشن: edsdoj.4e32b2d2a4514824bd16c7a6363853e1
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:08702551
DOI:10.1016/j.repc.2023.08.003