PURPOSE: To analyze maternal and fetal outcome in pregnant undergone to cardiac surgery. METHODS: We studied the evolution of 30 pregnant women submitted to cardiac surgery at the Hospital São Paulo, between Jan/81 and Dec/92 and, further, attended at this Hospital till the parturition. The following variables were analyzed: cardiopulmonary bypass, time of the procedure and time of the anoxia, patient temperature, surgical complications, and neonatal, maternal and fetal outcomes. RESULTS: All patients had rheumatic heart disease and, in 17, mitral stenosis was the main anatomic abnormality. Mitral commissurotomy was performed in 24 patients, double comissurotomy (mitral and aortic) in 1 patient and valve replacement was performed in 5. Cardiopulmonary bypass was utilized in all procedure; occurrence of surgical complications (p < 0.001) and the prolonged surgical time (p = 0.009) were related to the fetal mortality. There was 4 (13.3%) maternal deaths and 10 (33.3%) fetal deaths related to the surgery. CONCLUSION: The indication of cardiac surgery in pregnant women is heart failure, refractory to conventional therapy; cardiopulmonary bypass is associated with high fetal mortality.
PURPOSE: To analyze maternal and fetal outcome in pregnant undergone to cardiac surgery. METHODS: We studied the evolution of 30 pregnant women submitted to cardiac surgery at the Hospital São Paulo, between Jan/81 and Dec/92 and, further, attended at this Hospital till the parturition. The following variables were analyzed: cardiopulmonary bypass, time of the procedure and time of the anoxia, patient temperature, surgical complications, and neonatal, maternal and fetal outcomes. RESULTS: All patients had rheumatic heart disease and, in 17, mitral stenosis was the main anatomic abnormality. Mitral commissurotomy was performed in 24 patients, double comissurotomy (mitral and aortic) in 1 patient and valve replacement was performed in 5. Cardiopulmonary bypass was utilized in all procedure; occurrence of surgical complications (p < 0.001) and the prolonged surgical time (p = 0.009) were related to the fetal mortality. There was 4 (13.3%) maternal deaths and 10 (33.3%) fetal deaths related to the surgery. CONCLUSION: The indication of cardiac surgery in pregnant women is heart failure, refractory to conventional therapy; cardiopulmonary bypass is associated with high fetal mortality.