Procreation and pregnancy in patients with congenital heart disease

Background: Improvement in the treatment of congenital heart defects (CHD) prolongs survival time and provides the prospect of a better quality of life. The study was prompted by the increase in the CHD population of procreative age and the uncertainity related to procreation in CHD patients. Methods: We analysed 98 pregnancies of women with CHD and compared the results with demographic data. Analysis was made of educational level, work capacity, fertility, deteriora-tion in the clinical state and the percentages of labour at term and of vaginal births. Results: CHD occurred in different forms as follows — ASD: 35%, ToF: 17.5%, VSD: 13%, AS: 11%, others: 24%. Surgical treatment was performed on 56 % of cases. A total of 15 pregnancies were terminated by abortion. 78 % of deliveries were at term. Vaginal births accounted for 76 % of deliveries and caesarean section for 24%. The high-risk pregnancies accounted for stood at 36%. In all 85 children were born and 46 % underwent cardiological examination. Fertility measured as the number of live births in the relation to the number of women was 1.82. Women with ToF and AS had the lowest fertility and others with ASD II had 2.5, which exceeds that indicated by the demographic data. Conclusions: Patients with CHD have a higher educational level than average and 33 % of them are active at work. There is no difference in the fertility of our group in comparison with the demographic data. The rate of cardiological examination of the neonates of the mothers with CHD remains low. The nature of CHD involved in each case is the main factor that influences the fertility, course of the pregnancy and mode of delivery. (Folia Cardiol. 2006; 13: 379–383) Key words: congenital heart disease, procreation, pregnancie