ST. LOUIS — There were no maternal or fetal deaths in a study of 13 pregnant women with hypertrophic cardiomyopathy.
Women with this condition can have successful pregnancies with minimal risk to themselves and their babies, and should not be discouraged from becoming pregnant, Neeru Kaushik, M.D., reported in a poster presented at the annual meeting of the Midwest Society for Pediatric Research.
“Our understanding of hypertrophic cardiomyopathy has changed,” Dr. Kaushik said in an interview. “Most women with HCM don't need invasive monitoring during delivery.”
Dr. Kaushik and her colleagues at Magee-Women's Hospital in Pittsburgh reviewed 13 women aged 17–36 years with 16 pregnancies who were seen in the department of maternal-fetal cardiology from 1989 to 2005.
The women had maternal echocardiograms at 20 and 30 weeks' gestation and at 6 weeks post partum and fetal echocardiograms between 18 and 30 weeks' gestation. Maternal echocardiograms showed a median septal wall thickness of 2.3 cm, and the median predicted Doppler gradient in the left ventricular outflow tract was 37 mm Hg.
All the women delivered in a perinatal special care unit. One woman had a cesarean delivery, and the rest had assisted vaginal deliveries with a shortened second stage of labor. The maternal heart rates remained in the range of 70–80 beats per minute, controlled with atenolol or verapamil in most cases.
Central venous pressure used was not necessary, the investigators said.