Management of heart failure and timing of delivety in pregnancy

Abstract

Objective To explore the management of heart failure, the timing of delivery in pregnancy, and the influencce on pregnant prognosis. Methods We retrospectively analyzed the incidence of heart failure,treatment results, pattern of termination, and time of termination in 356 cases of pregnancy with heart disease.Results One hundred and thirty-six(38.20%) cases were diagnosed as heart failure and 76(55.88%) were moderate or severe heart failure. Heart failure tensd to occur more easily in rheumatic heart diseases than in congenital heart diseases. Heart failure occurred more ferquently in pregnancy with rheumatic heart diseases without the heart opeartion before pregnancy than that of pregnancy with congenital heart diseases. The occurrence of the moderate and severe heart failure in pregnancy decreased in rheumatic heart diseases with surgical therapies compared with those without surgical therapise(P< 0.05). Compatred with pregnancy with heart failure controlled inadequately,pregnancy with effectively controlled heart failure had better tolerance during delivery and through the pregnancy,and puerperium. Conclusions Congenital heart diseases and rheumatic heart diseases are the chiefcanses of heart failure during the gestation. Therapy before pregnancy, especially surgery to the rhumatic heart diseases, may improve the cardiac function during pregnancy. Monitoring heart function and selecting the proper timing to terminate pregnancy after controlling the heart failure in late pregnant period will be helpful to improve the prognosis of pregnant and perineonate. Key words: Pregnancy; Heart disease; Heart failure; Time of termination