Clinical analysis of Eisenmenger syndrome during pregnancy

Objective To investigate the outcome and the management of pregnant women with Eisenmenger syndrome during perinatal period to reduce the maternal fatality rate.Methods The clinical data of 23 pregnant women with Eisenmenger syndrome admitted into Beijing Anzhen Hospital Capital Medical University from January 1st,2001 to December 31st,2009 were retrospectively analyzed.Gestational week,primary disease of the heart,pulmonary hypertension,oxygen saturation and heart function of the patients were compared with Chi-square test or Fisher's exact test.Results (1) The gestational week of 23 patients with Eisenmenger syndrome were between 15 to 38 weeks,among which 11 cases in the midterm pregnancy and 12 in the last term pregnancy.The severity of pulmonary hypertension,heart function and pregnant outcomes have no difference in patients with differeut gestational weeks (P＞0.05).(2) Ventricular septal defect (VSD) were the most common disease (65.2％,15/23) among the four primary heart diseases of the patients.The heart function of the patients with VSD decreased most severely after pregnancy,and the fatality rate of the heart function Ⅳ was up to 73.3％ (11/15).The incidence of severe pulmonary hypertension was 20.0％ (3/15).The decreasing of the heart function of the patients with different primary heart diseases were different (P＜0.05).(3) Among the pulmonary hypertension patients,there were 7 mild cases (30.4％),12 moderate cases (52.2％) and 4 severe cases (17.4％).The severity of the pulmonary hypertension of the patients correlated to the incidence of postpartum heart failure and death (P＜ 0.05).The outcomes of four patients with severe pulmonary hypertension were the worst and all were reported to be dead (4/4).(4) Oxygen saturation related to the mortality of perinatal infants,incidence of premature birth and spontaneous abortion (P＜0.05).As oxygen saturation decreased to the lowest level,the fatality rate of perinatal infants increased to the highest (5.3 ％,1/19),so did the incidence of the premature birth (84.2％,16/19) and spontaneous abortion ( 10.5％,2/19).Conclusions The key point to increase the safety of patients with Eisenmenger syndrome during perinatal period was to strengthen monitoring,decrease the pulmonary hypertension and terminate pregnancy timely. Key words: Pregnancy complications, cardiovascular; Eisenmenger complex