FEATURES OF PREGNANCY AND DELIVERY IN WOMEN WITH UNREPAIRED ATRIAL AND VENTRICULAR SEPTAL DEFECTS
Vol. 6 No. 9 (2026) 7-11
Abstract
Congenital heart defects represent an important problem in modern cardio-obstetric practice, particularly unrepaired atrial and ventricular septal defects, in which the course of pregnancy is determined by the hemodynamic significance of the defect and the functional state of the cardiovascular system. This article summarizes current evidence on pregnancy, delivery, and the early postpartum period in women with unrepaired atrial and ventricular septal defects. Cardiovascular, obstetric, and perinatal complications, the effects of volume overload, pulmonary hypertension, and ventricular dysfunction on pregnancy outcomes, as well as current approaches to delivery management are considered. The available evidence indicates that, in the absence of significant hemodynamic abnormalities, pregnancy outcomes are favorable in most patients; however, these women require individualized risk assessment, dynamic monitoring, and multidisciplinary management.
Keywords:
References
Baumgartner H., De Backer J., Babu-Narayan S.V. et al. 2020 ESC Guidelines for the management of adult congenital heart disease // European Heart Journal. – 2021. – Vol. 42, № 6. – P. 563–645. – DOI: 10.1093/eurheartj/ehaa554.
Bredy C., Deville F., Huguet H. et al. Which risk score best predicts cardiovascular outcome in pregnant women with congenital heart disease? // European Heart Journal – Quality of Care and Clinical Outcomes. – 2023. – Vol. 9, № 2. – P. 177–183. – DOI: 10.1093/ehjqcco/qcac019.
Cardiovascular Outcomes in Pregnant Women With Ventricular Septal Defect: A National Inpatient Database Analysis // Journal of Cardiac Failure. – 2025. – Vol. 31, № 1. – P. 240. – DOI: 10.1016/j.cardfail.2024.10.153.
De Backer J., Haugaa K.H., Hasselberg N.E. et al. 2025 ESC Guidelines for the management of cardiovas-cular disease and pregnancy // European Heart Journal. – 2025. – Vol. 46, № 43. – P. 4462–4568. – DOI: 10.1093/eurheartj/ehaf193.
Gurvitz M., Krieger E.V., Fuller S. et al. 2025 ACC/AHA/HRS/ISACHD/SCAI Guideline for the Man-agement of Adults With Congenital Heart Disease: A Report of the American College of Cardiolo-gy/American Heart Association Joint Committee on Clinical Practice Guidelines // Journal of the American College of Cardiology. – 2026. – Vol. 87, № 7. – P. 822–976. – DOI: 10.1016/j.jacc.2025.09.006.
Halpern D.G., Penfield C.A., Feinberg J.L., Small A.J. Reproductive Health in Congenital Heart Disease: Preconception, Pregnancy, and Postpartum // Journal of Cardiovascular Development and Disease. – 2023. – Vol. 10, № 5. – Art. 186. – DOI: 10.3390/jcdd10050186.
Hardee I., Wright L., McCracken C. et al. Maternal and Neonatal Outcomes of Pregnancies in Women With Congenital Heart Disease: A Meta-Analysis // Journal of the American Heart Association. – 2021. – Vol. 10, № 8. – Art. e017834. – DOI: 10.1161/JAHA.120.017834.
Kecskemeti D., Nagy Z.S. et al. Outcome of preg-nancy in women with unrepaired atrial septal defect: study of a single tertiary centre // European Heart Jour-nal. – 2024. – Vol. 45, Suppl. 1. – Art. ehae666.2149. – DOI: 10.1093/eurheartj/ehae666.2149.
Lammers A.E., Diller G.P., Lober R. et al. Maternal and neonatal complications in women with congenital heart disease: a nationwide analysis // European Heart Journal. – 2021. – Vol. 42, № 41. – P. 4252–4260. – DOI: 10.1093/eurheartj/ehab571.
Liu Y., Li Y., Zhang J. et al. Pregnancy Complica-tions and Outcomes Among Women With Congenital Heart Disease in Beijing, China // Frontiers in Cardio-vascular Medicine. – 2022. – Vol. 8. – Art. 765004. – DOI: 10.3389/fcvm.2021.765004.
Martinez-Portilla R.J., Poon L.C., Benitez-Quintanilla L. et al. Incidence of pre-eclampsia and oth-er perinatal complications among pregnant women with congenital heart disease: systematic review and meta-analysis // Ultrasound in Obstetrics & Gynecology. – 2021. – Vol. 58, № 4. – P. 519–528. – DOI: 10.1002/uog.22174.
Sandberg M., Fomina T., Macsali F. et al. Preeclampsia and neonatal outcomes in pregnancies with maternal congenital heart disease: a nationwide cohort study from Norway // Acta Obstetricia et Gyne-cologica Scandinavica. – 2024. – Vol. 103, № 9. – P. 1847–1858. – DOI: 10.1111/aogs.14902.
Siu S.C., Colman J.M. Assessing Cardiac Risk in Pregnant Women With Heart Disease: How Risk Scores Are Created and Their Role in Clinical Practice // Cana-dian Journal of Cardiology. – 2020. – Vol. 36, № 4. – P. 516–525. – DOI: 10.1016/j.cjca.2020.02.079.
Wang T.K.M., Lowe B., Hlohovsky S., O'Donnell C. Performance of risk models predicting cardiac compli-cations in pregnant women with congenital heart dis-ease: a meta-analysis // Internal Medicine Journal. – 2020. – Vol. 50, № 4. – P. 481–484. – DOI: 10.1111/imj.14810.
Downloads
Published
Issue
Section
How to Cite
