Pregnancy with pre-excitation syndrome influence on pregnancy outcomes

Abstract

Objective: To investigate the characteristics of pregnancy with pre-excitation syndrome and its influence on pregnancy outcomes. Methods: A retrospective analysis was made on the clinical data of 62 cases of pregnancy complicated with pre-excitation syndrome in Beijing Anzhen Hospital from Jan. 2008 to Dec. 2008. According to whether there was a supraventricular tachycardia (SVT) in pregnancy, they were divided into two groups. There were 16 pregnant women in the SVT seizure group during pregnancy, and 46 pregnant women in no SVT seizure group, with a multi-disciplinary comprehensive diagnosis and treatment model. SPSS software was used to analyze the data and compare the gestational age, age and weight of the newborn, and then compare the pregnancy outcomes. Results: (1) The total number of deliveries in Beijing Anzhen Hospital during the study period was 21 786, and the patients with pregnancy combined with pre-excitation syndrome account for 0.28% (62/21 786). (2) Totally 44 patients (71%, 44/62) were diagnosed with pre-excitation syndrome before pregnancy, and 18 patients (29%, 18/62) were diagnosed for the first-time during pregnancy. Among patients diagnosed with pre-excitation syndrome before pregnancy, 16 patients (36%, 16/44) had seizures before pregnancy, 28 patients (64%, 28/44) had asymptomatic before pregnancy, and 4 of asymptomatic patients had SVT during pregnancy. (3) Of the 16 pregnant women in the SVT seizure group during pregnancy, 2 patients (2/16) had SVT episodes in the first trimester, 5 patients (5/16) had SVT episodes in the second trimester, 9 patients (9/16) had SVT episodes in the third trimester. In the SVT seizure group, 8 patients (8/16) had SVT episodes before pregnancy, and 8 patients (8/16) had no SVT episodes before pregnancy. There were 46 patients in the SVT seizure-free group during pregnancy, including 9 patients with SVT attacks before pregnancy and 37 patients without SVT before pregnancy. (4) Compared with the pregnant women in the SVT seizure group, the age, weight gained during pregnancy, delivery gestation week, newborn weight, and the time of the first and second labors were not statistically different between the two groups of pregnant women (all P>0.05). However, the total duration of labor in the SVT seizure group during pregnancy was shorter and pre-pregnancy weight was lower (all P<0.05). The rate of cesarean section in pregnant women with SVT attack was 12/16, and the rate of cesarean section in pregnant women without SVT was 50% (23/46; P=0.051). No pregnant woman had an arrhythmia during delivery. Conclusions: SVT episode in patients during pregnancy most occurs in the third trimester. Patients who are asymptomatic before pregnancy may also have SVT during pregnancy. Pre-excitation syndrome patients with SVT attacks during pregnancy increase adverse pregnancy outcomes. Multidisciplinary comprehensive management could effectively control pregnant women with pre-excitation syndrome, effectively reduce the occurrence of serious arrhythmia risk events during pregnancy, so that most patients could get good pregnancy outcomes.