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  • Open Access

    ARTICLE

    Long Term Follow-Up of Ebstein’s Anomaly—What to Expect in Adult Life?

    Tânia Branco Mano1,*, João Ferreira Reis1, Ana Figueiredo Agapito1, André Monteiro1, Mário Oliveira1, Luísa Moura Branco1, José Fragata2, Fátima Pinto3, Rui Cruz Ferreira1, Lídia de Sousa1

    Congenital Heart Disease, Vol.15, No.3, pp. 153-162, 2020, DOI:10.32604/CHD.2020.011500 - 15 July 2020

    Abstract Introduction: Due to the low prevalence and wide variation of severity of Ebstein’s Anomaly (EA), long-term follow-up data are scarce. The aim was to evaluate the long-term outcome of an adult population with EA. Methods: Retrospective analysis of EA adults followed in the past 42 years in a tertiary congenital heart disease outpatient clinic. Predictors of complications and mortality were assessed. Results: We studied 53 patients: 53% females, mean age 46 ± 19 years, 36% cyanotic, 55% diagnosed at adult age. Tricuspid regurgitation was moderate or severe in 33% and 46%, respectively, and during follow-up (mean… More >

  • Open Access

    ARTICLE

    The role of inflammatory markers hs-CRP, sialic acid, and IL-6 in the pathogenesis of preeclampsia and intrauterine growth restriction

    Ayse Ekin Kara1, Gurhan Guney1,2, Aytekin Tokmak1, Gulnur Ozaksit1

    European Cytokine Network, Vol.30, No.1, pp. 29-33, 2019, DOI:10.1684/ecn.2019.0423

    Abstract Objective: The aim of our study was to evaluate serum high-sensitivity C-Reactive Protein (hs-CRP), sialic acid (SA), and interleukin-6 (IL-6) levels in pregnancies complicated with preeclampsia (PE) and intrauterine growth restriction (IUGR) and to compare with healthy pregnancies. Materials and Methods: This study was conducted at a tertiary-level maternity hospital with 80 pregnant women. Fasting blood samples were taken from 44 consecutive women with pregnancies complicated by PE (n: 20) and IUGR (n: 24), and 36 were from normal pregnancies. Serum hs-CRP, SA, and IL-6 concentrations were measured in all participants. Results: Serum mean hs-CRP,… More >

  • Open Access

    ARTICLE

    Secular trends in pregnancy rates, delivery outcomes, and related health care utilization among women with congenital heart disease

    Natalie Bottega1, Isabelle Malhamé2, Liming Guo1, Raluca Ionescu‐Ittu1, Judith Therrien1, Ariane Marelli1

    Congenital Heart Disease, Vol.14, No.5, pp. 735-744, 2019, DOI:10.1111/chd.12811

    Abstract Background: The number of women with congenital heart disease (CHD) of reproductive age is increasing, yet a description of trends in pregnancy and delivery outcomes in this population is lacking.
    Objective: To assess secular trends in pregnancy rates, delivery outcomes, and related health care utilization in the adult female CHD population in Quebec, Canada.
    Methods: The Quebec CHD database was used to construct a cohort with all women with CHD aged 18‐45 years between 1992 and 2004. Pregnancy and delivery rates were determined yearly and compared to the general population. Secular trends in pregnancy and delivery rates were… More >

  • Open Access

    ARTICLE

    Accuracy of risk prediction scores in pregnant women with congenital heart disease

    Yuli Y. Kim1,2, Leah A. Goldberg2, Katherine Awh2, Tanmay Bhamare1,2, David Drajpuch2, Adi Hirshberg3, Sara L. Partington1,2, Rachel Rogers4, Emily Ruckdeschel1,2, Lynda Tobin1, Morgan Venuti2, Lisa D. Levine3

    Congenital Heart Disease, Vol.14, No.3, pp. 470-478, 2019, DOI:10.1111/chd.12750

    Abstract Objective: To assess performance of risk stratification schemes in predicting adverse cardiac outcomes in pregnant women with congenital heart disease (CHD) and to compare these schemes to clinical factors alone.
    Design: Single‐center retrospective study.
    Setting: Tertiary care academic hospital.
    Patients: Women ≥18 years with International Classification of Diseases, Ninth Revision, Clinical Modification codes indicating CHD who delivered between 1998 and 2014. CARPREG I and ZAHARA risk scores and modified World Health Organization (WHO) criteria were applied to each woman.
    Outcome Measures: The primary outcome was defined by ≥1 of the following: arrhyth‐ mia, heart failure/pulmonary edema, transient ischemic attack, stroke,… More >

  • Open Access

    ARTICLE

    Fetal heart size measurements as new predictors of homozygous α-thalassemia-1 in mid-pregnancy

    Xinyan Li1, Xiaoxia Qiu1, Huan Huang1, Yili Zhao2, Xueqin Li1, Meng Li1, Xiaoxian Tian1

    Congenital Heart Disease, Vol.13, No.2, pp. 282-287, 2018, DOI:10.1111/chd.12568

    Abstract Objective: To evaluate the efficacy of using fetal heart size measurements derived from axial echocardiography to predict homozygous α-thalassemia-1.
    Design: Prospective diagnostic study.
    Setting: The carrier rate of α-thalassemia-1 (–/αα) in China’s Guangxi Zhuang Autonomous Region is approximately 15%. If both parents are carriers, the risk of homozygous a-thalassemia-1 in one pregnancy is 25%.
    Patients: Singleton mid-pregnancies at risk of homozygous α-thalassemia-1 were enrolled.
    Outcome Measures: Fetal heart measurements, including heart diameter (HD), heart length (HL), heart circumference (HC), and heart area (HA), were measured. The z-scores for these heart parameters were then calculated separately based on previously constructed z-score… More >

  • Open Access

    ARTICLE

    Impact of pregnancy on autograft dilatation and aortic valve function following the Ross procedure

    Horacio G. Carvajal1,2, Kathryn J. Lindley3, Trupti Shah1, Anoop K. Brar1, Philip M. Barger3, Joseph J. Billadello3, Pirooz Eghtesady1

    Congenital Heart Disease, Vol.13, No.2, pp. 217-221, 2018, DOI:10.1111/chd.12554

    Abstract Objective: The effects of pregnancy on autograft dilatation and neoaortic valve function in patients with a Ross procedure have not been studied. We sought to evaluate the effect of pregnancy on autograft dilatation and valve function in these patients with the goal of determining whether pregnancy is safe after the Ross procedure.
    Design: A retrospective chart review of female patients who underwent a Ross procedure was conducted.
    Patients: Medical records for 51 patients were reviewed. Among the 33 patients who met inclusion criteria, 11 became pregnant after surgery and 22 did not.
    Outcome Measures: Echocardiographic reports were used to… More >

  • Open Access

    REVIEW

    Cardiovascular outcomes of pregnancy in Marfan’s syndrome patients: A literature review

    So Yeon Kim1,2, Diana S. Wolfe2, Cynthia C. Taub2

    Congenital Heart Disease, Vol.13, No.2, pp. 203-209, 2018, DOI:10.1111/chd.12546

    Abstract Aims: Pregnancy in patients with Marfan’s syndrome (MFS) carries an increased risk of cardiovascular complications, resulting in increased maternal and fetal mortality and morbidity. Literature on MFS pregnant patients is relatively sparse, and there has yet to be a concrete consensus on the management of this unique patient population. The purpose of our paper is to provide a literature review of case reports and studies on MFS during pregnancy (published between 2005 and 2015) and to explore cardiovascular outcomes of patients with MFS.
    Methods and Results: Of the 852 women in our review, there were 1112 pregnancies,… More >

  • Open Access

    RESIDENT’S CORNER

    Bilateral obstructing ureteric calculi in pregnancy: a rare cause of acute renal failure

    Todd G. Manning1,2, Daniel Christidis1,2, David Wetherell1,2, Ruth Cameron-Jeffs3, Nathan Lawrentschuk1,4,5

    Canadian Journal of Urology, Vol.24, No.2, pp. 8770-8772, 2017

    Abstract Bilateral obstructing ureteric calculi is a rare cause of acute renal failure. Although urolithiasis in later pregnancy is not uncommon, the development of bilateral obstruction secondary to ureteric calculi in the first trimester is rare and poses difficulty to diagnosis and management. Symptoms of diseases and physiological changes associated with pregnancy can obscure diagnosis of urolithiasis and obstructive uropathy. Advances in minimally invasive endourology afford intervention with reduced risk to fetal health. We present the second case of acute renal failure caused by bilateral obstructing ureteric calculi in a pregnant patient and discuss current management More >

  • Open Access

    REVIEW

    Pregnancy-related acute aortic dissection in Marfan syndrome: A review of the literature

    Katherine Smith, Bernard Gros

    Congenital Heart Disease, Vol.12, No.3, pp. 251-260, 2017, DOI:10.1111/chd.12465

    Abstract A well-established association exists between acute aortic dissection and pregnancy, particularly in women with Marfan syndrome. However, there is debate regarding appropriate management guidelines. In particular, there are differing opinions regarding when prophylactic aortic root repair should be recommended as well as the efficacy of beta blockers in this clinical scenario. The current study evaluated 10 years of published literature (2005-2015) in the PubMed/Medline database. Fifty articles, describing 72 cases of women who presented with aortic dissection in the antepartum or postpartum period were identified. Comparisons on demographic variables and clinical outcomes between cases of… More >

  • Open Access

    RESIDENT’S CORNER

    Early pregnancy likely caused by an intravesical intrauterine device

    Jim K. Shen, Edmund Y. Ko, Andrea Staack

    Canadian Journal of Urology, Vol.23, No.5, pp. 8487-8490, 2016

    Abstract A 42-year-old female with remote history of intrauterine device (IUD) placement presented with gross hematuria, urinary urgency, and dyspareunia. Cystoscopy showed an encrusted, free-floating intravesical foreign body consistent with a heavily calcified IUD. It was removed endoscopically using holmium laser cystolitholapaxy. The patient remained symptom free postoperatively. While most intravesical IUDs are thought to be the result of migration after several months, this patient became pregnant within 4 weeks after initial insertion. Therefore this may represent a case either of early intravesical migration or of accidental IUD placement into the bladder at the time of More >

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