Outcomes of pregnancy in women with hypertrophic cardiomyopathy

A systematic review of maternal and fetal outcomes of pregnancy in patients with hypertrophic cardiomyopathy published in International Journal of Cardiology. A literature search for studies reporting maternal or fetal outcomes in pregnant women with hypertrophic cardiomyopathy was done. Primary outcomes included maternal death, stillbirth, and fetal death. Secondary maternal outcomes included both sustained and non-sustained ventricular tachycardia (VT), atrial fibrillation, heart failure (HF), syncope, cesarean delivery, and preeclampsia/eclampsia. The secondary fetal outcome was preterm birth.

 A total of 18 studies with 1624 pregnancies. The incidence of maternal death was 0.2%. The rates of sustained ventricular tachycardia, any ventricular tachycardia (including non-sustained), atrial fibrillation, heart failure, and syncope were 1% (0–1%), 6% (4–8%), 4% (2–6%), 5% (3–8%), and 9% (3–14%), respectively. Postpartum hemorrhage, preeclampsia/eclampsia, and cesarean section complicated 2% (1–4%), 4% (2–6%), and 43% (32–54%) of pregnancies, respectively. Neonatal death occurred in 0.2% of pregnancies. Stillbirth complicated 1% (95% CI, 0–3%) of pregnancies, whereas the incidence of preterm birth was 22% (95% CI, 18–25%).

Researchers concluded that women with hypertrophic cardiomyopathy considering pregnancy can be reassured that the risk of maternal, fetal, or neonatal death is low. However, they are at risk of several non-fatal cardiac and pregnancy-related complications.