30 Managing delivery in women with congenital heart disease: results from the cuban national programme for pregnancy and heart disease

Abstract

Purpose To provide an update on the delivery outcomes achieved in congenital heart disease (CHD) patients by the Cuban National Programme for Pregnancy and Heart Disease. Methods This was a single-centre retrospective study on a prospectively collected database from 1 st January 2000 to 15th May 2017. Baseline data: demographics (age, province of origin), diagnosis, co-morbidities and functional status. Primary outcomes: duration of pregnancy, pregnancy outcome, any maternal or fetal complications. Results Overall 467 pregnancies in 462 women reached the third trimester. Median age was 25 (21–29) years, with 71% of cases originating from Havana. Patients presented in NYHA class I (97%, n=453) or II (3%, n=14), 6% (n=27) of patients had arrhythmias, 1% (n=4) had significant co-morbidities, and 1% (n=4) had impaired left ventricular function. One pregnancy resulted in stillbirth, with the rest (n=466) resulting in live births (n=469) of median birth weight 3200 (2880–3420) grams. Median duration of gestation was 39 (38.6–40) weeks. Sixty-six percent (n=307) of patients had a vaginal delivery; caesarean section rates were 34% (n=161). Maternal cardiovascular complications ( Conclusion Despite considerable resource constraints, in middle-income countries management of CHD pregnancies according to existing guidelines can achieve excellent outcomes.