Imperial College London
Alternate

ProfessorMarkJohnson

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Chair in Obstetrics
 
 
 
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Contact

 

+44 (0)20 3315 7887mark.johnson

 
 
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Location

 

H3.35Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Roos-Hesselink:2019:eurheartj/ehz136,
author = {Roos-Hesselink, J and Baris, L and Johnson, M and De, Backer J and Otto, C and Marelli, A and Jondeau, G and Budts, W and Grewal, J and Sliwa, K and Parsonage, W and Maggioni, AP and van, Hagen I and Vahanian, A and Tavazzi, L and Elkayam, U and Boersma, E and Hall, R},
doi = {eurheartj/ehz136},
journal = {European Heart Journal},
pages = {3848--3855},
title = {Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC)},
url = {http://dx.doi.org/10.1093/eurheartj/ehz136},
volume = {40},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AIMS: Reducing maternal mortality is a World Health Organization (WHO) global health goal. Although maternal deaths due to haemorrhage and infection are declining, those related to heart disease are increasing and are now the most important cause in western countries. The aim is to define contemporary diagnosis-specific outcomes in pregnant women with heart disease. METHODS AND RESULTS: From 2007 to 2018, pregnant women with heart disease were prospectively enrolled in the Registry Of Pregnancy And Cardiac disease (ROPAC). Primary outcome was maternal mortality or heart failure, secondary outcomes were other cardiac, obstetric, and foetal complications. We enrolled 5739 pregnancies; the mean age was 29.5. Prevalent diagnoses were congenital (57%) and valvular heart disease (29%). Mortality (overall 0.6%) was highest in the pulmonary arterial hypertension (PAH) group (9%). Heart failure occurred in 11%, arrhythmias in 2%. Delivery was by Caesarean section in 44%. Obstetric and foetal complications occurred in 17% and 21%, respectively. The number of high-risk pregnancies (mWHO Class IV) increased from 0.7% in 2007-2010 to 10.9% in 2015-2018. Determinants for maternal complications were pre-pregnancy heart failure or New York Heart Association >II, systemic ejection fraction <40%, mWHO Class 4, and anticoagulants use. After an increase from 2007 to 2009, complication rates fell from 13.2% in 2010 to 9.3% in 2017. CONCLUSION: Rates of maternal mortality or heart failure were high in women with heart disease. However, from 2010, these rates declined despite the inclusion of more high-risk pregnancies. Highest complication rates occurred in women with PAH.
AU  - Roos-Hesselink,J
AU  - Baris,L
AU  - Johnson,M
AU  - De,Backer J
AU  - Otto,C
AU  - Marelli,A
AU  - Jondeau,G
AU  - Budts,W
AU  - Grewal,J
AU  - Sliwa,K
AU  - Parsonage,W
AU  - Maggioni,AP
AU  - van,Hagen I
AU  - Vahanian,A
AU  - Tavazzi,L
AU  - Elkayam,U
AU  - Boersma,E
AU  - Hall,R
DO  - eurheartj/ehz136
EP  - 3855
PY  - 2019///
SN  - 1522-9645
SP  - 3848
TI  - Pregnancy outcomes in women with cardiovascular disease: evolving trends over 10 years in the ESC Registry Of Pregnancy And Cardiac disease (ROPAC)
T2  - European Heart Journal
UR  - http://dx.doi.org/10.1093/eurheartj/ehz136
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30907409
UR  - http://hdl.handle.net/10044/1/71426
VL  - 40
ER  -
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