Index Spots Pregnancy Risks For Women With Heart Disease.(health risk index)

2001 AUG 23 - (NewsRx Network) -- A risk index can predict the extent of pregnancy complications in women who have heart conditions, which means those at high risk can be directed to specialized treatment facilities, according to the comprehensive study published in the July 31, 2001, issue of Circulation.

Despite modern obstetric and cardiac care, pregnancy in women with heart disease can be associated with significant complications to the health of the mother and child. Current risk estimates are primarily based on retrospective studies, a particular type of heart disease or examined cases at a specific hospital. This is the first large-scale study taking a prospective look at the frequency and predictors of pregnancy-related complications for a broad range of heart conditions.

"It is relatively uncommon for women who are pregnant to have heart disease. In most past studies looking at these conditions, heart disease in pregnant women usually comprises no more than 1% or 2% of the total pregnant population," says study author Samuel C. Siu, MD, a cardiologist and associate professor at University of Toronto, Ontario. "Because it is so uncommon, the problem is more vulnerable to misinformation and sometimes lack of information."

This study developed a method of categorizing pregnant patients with heart disease into broad categories of risk - including low, medium, and high - which will allow the appropriate care of these patients or the appropriate referral to specialized care centers, he says.

Siu and his colleagues studied 562 pregnant women with heart disease in 13 Canadian cardiac and obstetric teaching hospitals and recorded the outcomes of 599 pregnancies. (Some of the women were pregnant more than once during the five-year study.) Eighty-six percent of the women were between 18 and 35 years of age. Most of the women had a form of congenital heart disease (74%), meaning she's had the condition since birth. Others had acquired heart disease (22%) or irregular heart rhythms called arrhythmias (4%).

The good news to come from the study, according to Siu, was that researchers found that the majority of women fared well through pregnancy. In 13% of the pregnancies, women experienced serious heart-related complications including fluid in the lungs, arrhythmia, stroke, or death. Three women (1%) died from their heart complications.

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