Korean J Obstet Gynecol.  2006 Apr;49(4):831-839.

Eisenmenger syndrome in pregnancy at second and third trimester

• Kang KH
• Kim BJ
• Sohn YK
• Lee SE
• Kim MK
• Shim SS
• Park JS
• Jun JK
• Yoon BH
• Syn HC

Abstract

OBJECTIVE
Because women with Eisenmenger syndrome are counseled strongly not to conceive, pregnancy cases with Eisenmenger syndrome are rare in clinical situation. We performed this study to analyze pregnancies at second and third trimester complicated by Eisenmenger syndrome and to evaluate changes during pregnancy and their outcomes.
METHODS
Medical records were reviewed retrospectively for Eisenmenger syndrome patients who delivered at second and third trimester at Seoul National University Hospital from January 1989 to October 2005.
RESULTS
Among the total of 6 pregnant women, 4 women delivered after 34 weeks and 2 women had therapeutic termination during second trimester. All 4 women who delivered after 34 weeks were categorized as class III by New York Heart Association classification. Maternal mortality rate was 33% (2 of 6 cases). All mortality cases were patients who delivered after 34 weeks. All neonates were small for gestational age with no neonatal death. There was no neonatal morbidity except one case of congenital atrial septal defect.
CONCLUSION
Maternal mortality occurred in half of the women who continued their pregnancy beyond second trimester. We think that pregnancy should be still discouraged in patients with Eisenmenger syndrome and that therapeutic abortion should be offered in early pregnancy period.

Keyword

Eisenmenger syndrome; Pregnancy outcome; Maternal mortality

MeSH Terms

Abortion, Therapeutic
Classification
Eisenmenger Complex*
Female
Gestational Age
Heart
Heart Septal Defects, Atrial
Humans
Infant, Newborn
Maternal Mortality
Medical Records
Mortality
Pregnancy Outcome
Pregnancy Trimester, Second
Pregnancy Trimester, Third*
Pregnancy*
Pregnant Women
Retrospective Studies
Seoul