Eisenmenger syndrome in pregnancy at second and third trimester.

Kang, Kue Hyun; Kim, Byoung Jae; Sohn, Yoo Kyung; Lee, Si Eun; Kim, Mi Kyung; Shim, Soon Sup; Park, Joong Shin; Jun, Jong Kwan; Yoon, Bo Hyun; Syn, Hee Chul

Original Article

Korean Journal of Obstetrics & Gynecology 2006;49(4):831-839.
Published online April 1, 2006.

Eisenmenger syndrome in pregnancy at second and third trimester.

Kue Hyun Kang, Byoung Jae Kim, Yoo Kyung Sohn, Si Eun Lee, Mi Kyung Kim, Soon Sup Shim, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon, Hee Chul Syn

Seoul National University, College of Medicine, Obstetrics and Gynecology, Seoul, Korea. shim212@snu.ac.kr

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.

Key Words: Eisenmenger syndrome, Pregnancy outcome, Maternal mortality