Mode of delivery in pregnancies complicated by major fetal congenital heart disease: a retrospective cohort study

Journal of Perinatology : Official Journal of the California Perinatal Association
C A WalshF M McAuliffe

Abstract

To determine the mode of delivery in pregnancies complicated by complex fetal congenital heart disease (CHD). Five-year retrospective cohort study at a tertiary fetal medicine center (2007 to 2011). Cases of complex fetal CHD (n=126) were compared with 45 069 non-anomalous singleton infants ⩾500 g to determine rates of emergency intrapartum cesarean section (CS), preterm delivery and induction of labor. Intrapartum CS is significantly higher in fetal CHD than non-anomalous controls (21% vs 13.5%, odds ratio (OR) 1.7, 95% confidence interval (CI): 1.0 to 2.7; P=0.035), predominantly related to CS for non-reassuring fetal status (OR 2.2, 95% CI: 1.1 to 4.1; P=0.022). Although fetal CHD did not increase emergency CS rates in nulliparous women, CS was significantly increased in multiparous pregnancies (OR 2.4, 95% CI: 1.8 to 4.6; P=0.014). Rates of preterm delivery (OR 3.4, 95% CI: 2.0 to 5.4; P<0.0001) and induction of labor (OR 1.9, 95% CI: 1.3 to 2.9; P=0.001) were higher in the CHD cases. Emergency CS is increased in fetal CHD, attributed to a higher rate of CS for non-reassuring fetal status and seen mostly in multiparous women.

References

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Citations

Feb 16, 2016·Clinics in Perinatology·Laura SanapoMary T Donofrio
Apr 1, 2015·Seminars in Fetal & Neonatal Medicine·Jay D PruetzDavid A Miller
Nov 29, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Takekazu MiyoshiTomoaki Ikeda
Mar 17, 2018·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Cathy LiuSailesh Kumar
Aug 30, 2018·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Mehmet Resit AsogluOzhan M Turan
Oct 16, 2019·Journal of Perinatology : Official Journal of the California Perinatal Association·April D AdamsSara N Iqbal
Jul 10, 2020·American Journal of Perinatology·Talia ConeyAnna Palatnik

Related Concepts

Atrioventricular Septal Defect
Embryopathies
Congenital Heart Defects
Heart Septal Defects
Pregnancy Outcome
Retrospective Studies
Hypoplastic Left Heart Syndrome
Obstetric Delivery
Birth
Fetal Heart

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