Predictors for Complications in Pregnant Women with Heart Disease, a Retrospective Study
Saowapark Chumpathong MD*, Chuleeporn Sirithaweesit MD*, Nuchsaroch Pechpaisit MD*, Suwannee Suraseranivongse MD*, Benno von Bormann MD*, Vitaya Titapant MD**, Sudta Parakkamodom RN*
Affiliation : * Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Evaluate the CARPREG score in predicting cardiac, obstetric, and neonatal complications in pregnant women
with heart disease.
Material and Method: This was a retrospective study between 2002 and 2011 at a tertiary care center and included
175 pregnant women with heart disease. Maternal and neonatal outcomes were assessed using Cardiac in Pregnancy Score
(CARPREG), which included NYHA-class, systolic ejection fraction, left ventricular obstruction, and history of cardiac
events.
Results : Rheumatic heart disease (n = 116, 66.3%) was the predominant cardiac problem. CARPREG score was 0, 1, >1
in 65.1%, 24.6%, and 10.3% pregnancies, respectively. Maternal cardiac events occurred in 27.4%. CARPREG score ≥1
was associated with an increased rate of cardiac events [odds ratio (OR) 6.76, 95% confidence interval (CI) 3.26 to 14.01].
Fetal complications occurred 24.4%. Neonatal birth weight <2,500 g was associated with CARPREG score ≥1 (OR 2.57,
95% CI 1.29 to 5.11).
Conclusion : Maternal cardiac events can be predicted using CARPREG risk index. In Thai population, rheumatic heart
disease was the most frequent form of cardiac problems in pregnant women.
Keywords : Pregnancy, Heart disease, Complication, CARPREG score, Neonatal outcome
