Hemodynamic features of pregnant women with atrial septal defect in the third trimester of pregnancy: A literature review
Due to the decline in mortality rates among children with heart disease, a significant number of such children have reached reproductive age. However, since knowledge about the impact of pregnancy on haemodynamics in women with heart disease is limited, this study is extremely relevant. The study aimed to provide a comprehensive review of current scientific sources and consolidate the knowledge gained on haemodynamic features in pregnant women with atrial septal defects. Several methods were used in the study: analysis, including comparative analysis, synthesis, bibliography, systematisation, and categorisation. A two-stage approach in the form of a systematic literature review was also used. The complex haemodynamic changes that occur in pregnant women, both in normal and pathological conditions, in particular in pregnant women with atrial septal defect, are considered. The question is specified as to why hemodynamic changes become most significant in the third trimester of pregnancy, their impact on the course of pregnancy, and the outcome of labor completion. The topic of acute and chronic complications of atrial septal defect and modern principles of their prevention and treatment are covered. Special attention is paid to the methods of correction of this heart defect, considering their advantages, disadvantages and possible complications. The experience of perinatal centres in several European countries in managing pregnancies in women with cardiovascular disease, in particular with atrial septal defects, is reviewed. Gaps in knowledge about the prevalence of these defects and risk factors were filled. The study addressed the lack of a comprehensive view of this problem: from pathophysiological basis and epidemiology to treatment and modification of risk factors. The study is of great practical value for healthcare professionals, as it can serve as a basis for the development of preventive programmes and other interventions for pregnancies of women with congenital cardiovascular disease
congenital malformations; gestation; cardiovascular complications; risk factors; open oval window; pulmonary hypertension
https://doi.org/10.61751/ijmmr.2413-6077.2023.1.60[1] Yaroslavskyi V, Tsysar Yu. Modern views on the course of cardiovascular pathology during pregnancy. Med Forum. 2021;24(24):102–4
[2] Triska S, Vasiuk, Yu, Yashan N. Congenital and acquired heart defects and pregnancy: Features of pregnancy and delivery management. South Ukr Med Sci J. 2019;23(23):11–3
[3] Kravchuk I, Kurtash N, Kusa O, Neiko O, Snizhko T. Algorithm for the management of pregnant women with thrombophilia. In: Pluzhnik E, Polyvana L, Mushenyk I, Prudka L, Marchenko D, Harchenko R, et al., editors. Young Scientists and Methods of Improving Modern Theories. Proceedings of the II International Scientific and Practical Conference; 2023; Milan, Italy. International Science Group. 2023. P. 110–4. DOI: 10.46299/ISG.2023.2.2
[4] Kryvetskyi V, Rotar H, Protsak T, Shafraniuk V. Congenital heart defects: Current state and present issues. Clin Anat Oper Surg. 2018;17(1):108–13. DOI: 10.24061/1727-0847.17.1.2018.18
[5] Shevchenko T, Shaposhnyk O, Sorokina S, Kudrya I, Efremenko V. Features of management of patients with late diagnosed congenital heart disease. World Med Biol. 2019;1(67):111–16. DOI: 10.26724/2079-8334-2019-1-67-111
[6] Boell SK, Cecez-Kecmanovic D. On being “systematic” in literature reviews in IS. J Inform Technol. 2015;30(2):161–73. DOI: 10.1057/jit.2014.26
[7] Khudoykulova N. Congenital anomalies, their analysis and development in the Navoi region. Int J Philos Stud Soc Sci. 2022;2(2):46–49
[8] Protsak T, Khovanets K. Developmental cardiovascular anomalies. Med Forum. 2018;15(15):61–63.
[9] Murzakanova G, Räisänen S, Jacobsen AF, Yli BM, Tingleff T, Laine K. Trends in term intrapartum stillbirth in Norway. JAMA Netw Open. 2023;6(9):e2334830. DOI: 10.1001/jamanetworkopen.2023.34830
[10] Frescura C, Thiene G. In Thiene, G., Basso, C., Rizzo, S., Della Barbera, M., Valente, M., Bortolotti, U., editors. Congenital anomalies of the cardiac valves. Pathology of Cardiac Valve Disease. Cham: Springer International Publishing; 2023. P. 63–86. DOI: 10.1007/978-3-031-35498-4_5
[11] Gelb BD. Prospects for precision genetic medicine in congenital heart disease. Curr Opin Genet Dev. 2022;77:e101983. DOI: 10.1016/j.gde.2022.101983
[12] Wen X, Belviso N, Murray E, Lewkowitz AK, Ward KE, Meador KJ. Association of gestational opioid exposure and risk of major and minor congenital malformations. JAMA Netw Open. 2021;4(4):e215708. DOI: 10.1001/jamanetworkopen.2021.5708
[13] Mallah N, Tohidinik HR, Etminan M, Figueiras A, Takkouche B. Prenatal exposure to macrolides and risk of congenital malformations: A meta-analysis. Drug Saf. 2020;43:211–21. DOI: 10.1007/s40264-019-00884-5
[14] Liang Z, Yin M, Ma M, Wang Y, Kuang Y. Effect of maternal advanced endometriosis on risk of congenital malformations for infants born after in vitro fertilization and frozen-thawed embryo transfer: analysis of 28,600 newborns. Front Endocrinol. 2019;10:e763. DOI: 10.3389/fendo.2019.00763
[15] Costa NZ, Nora CRD, Souto LHD, Carlotto FD, Afonso, RDS, Riquinho DL. Exposure to toxic agrochemicals and development of congenital malformations: A scoping review. Texto Contexto-Enfermagem. 2021;30:e20200372. DOI: 10.1590/1980-265X-TCE-2020-0372
[16] de Ramírez-Altamirano MJ, Fenton-Navarro P, Sivet-Chiñas E, Harp-Iturribarria Fde M, Martínez-Cruz R, Cruz PH, et al. The relationship of aluminium and silver to neural tube defects; a case control. Iran J Pediatr. 2012;22(3):369–74
[17] Seyi-Olajide JO, Ma X, Guadagno E, Ademuyiwa A, Poenaru D. Screening methods for congenital anomalies in low and lower-middle income countries: A systematic review. J Pediatr Surg. 2023;58(5):986–93. DOI: 10.1016/j.jpedsurg.2023.01.038
[18] Xia Y, Cheng L, Duan J, Ma J, Zhang Y. Identification of gravida serum biomarkers for noninvasive prenatal diagnosis foetal congenital heart disease. J Cardiovasc Trans Res. 2023;16:255–66. DOI: 10.1007/s12265-022-10301-5
[19] Konovalova M, Mykhailovska N. The impact of concomitant anemic syndrome on the clinical course of coronary artery disease. Pathol. 2021;18(3):263–8. DOI: 10.14739/2310-1237.2021.3.237926
[20] Troiano NH. Physiologic and hemodynamic changes during pregnancy. AACN Adv Crit Care. 2018;29(3):273–83. DOI: 10.4037/aacnacc2018911
[21] Ren J, Fan Z, Li J, Wang Y, Zhang J, Hua S. Blood pressure patterns of hypertensive disorders of pregnancy in first and second trimester and contributing factors: A retrospective study. J Obstet Gynaecol. 2023;43(1):e2171776. DOI: 10.1080/01443615.2023.2171776
[22] Sima RM, Findeklee S, Bădărău IA, Poenaru MO., Scheau C, Pleș L. Comparison of maternal third trimester hemodynamics between singleton pregnancy and twin pregnancy. J Perinat Med. 2021;49(5):566–71. DOI: 10.1515/jpm-2020-0169
[23] Pascual ZN, Langaker MD. Physiology, pregnancy [Internet]. Treasure Island: StatPearls Publishing; 2023 [cited 2023 Nov 28]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559304/
[24] Warren BB, Moyer GC, Manco-Johnson MJ. Hemostasis in the pregnant woman, the placenta, the fetus, and the newborn infant. Semin Thromb Hemost. 2023;49(4):319–29. DOI: 10.1055/s-0042-1760332
[25] Bester M, Joshi R, Mischi M, van Laar JOEH, Vullings R. On the distinct differences in autonomic regulation between pregnant and non-pregnant women-a heart rate variability analysis. Physiol Meas. 2023;44(5):e055001. DOI: 10.1088/1361-6579/acce1e
[26] Binh VT, Thi H, Anh HD, Anh NT, Thanh BD, Pho DC, et al. Assessment of morphological and hemodynamic changes in adult atrial septal defect before and after percutaneous trans-catheter closure: The initial result in Vietnamese patient. Eur Rev Med Pharmacol Sci. 2022;26(24):9240–49. DOI: 10.26355/eurrev_202212_30677
[27] Muroke V, Jalanko M, Haukka J, Sinisalo J. Cause‐specific mortality of patients with atrial septal defect and up to 50 years of follow‐up. J Am Heart Assoc. 2023;12(2):e027635. DOI: 10.1161/JAHA.122.027635
[28] Sjöberg P, Arheden H, Heiberg E, Stephensen S, Carlsson M. Haemodynamic left-ventricular changes during dobutamine stress in patients with atrial septal defect assessed with magnetic resonance imaging-based pressure-volume loops. Clin Physiol Funct Imaging. 2022;42(6): 422–29. DOI: 10.1111/cpf.12781
[29] Cool CJ, Kamarullah W, Pranata R, Putra ICS, Khalid AF, Akbar MR, et al. A meta-analysis of atrial septal defect closure in patients with severe pulmonary hypertension: is there a room for poking holes amidst debate? Curr Probl Cardiol. 2023:e102121. DOI: 10.1016/j.cpcardiol.2023.102121
[30] Bradley EA, Zaidi AN. Atrial septal defect. Cardiol Clin. 2020;38(3):317–24. DOI: 10.1016/J.CCL.2020.04.001
[31] Potapchuk A, Onipko Y, Almashi V, Rak Y, Hegedűs C, Kryvanych V, Sheveria S. Evaluation of dynamic changes in the microcirculation of the mucosa in the zone of dental implantation with immediate intraoperative load. Med Adv. 2023;76(9):1891–9. DOI: 10.36740/WLek202309101
[32] Kadirogullari E, Onan B, Timur B, Birant A, Reyhancan A, Basgoze S, Aydin U. Transcatheter closure vs totally endoscopic robotic surgery for atrial septal defect closure: A single‐center experience. J Card Surg. 2020;35(4):764–71. DOI: 10.1111/jocs.14456
[33] Qiu HF, Chen Q, Hong Z-N, Chen LW, Huang XS. Transcatheter and intraoperative device closure and surgical repair for atrial septal defect. J Cardiothorac Surg. 2019;14:e136. DOI: 10.1186/s13019-019-0957-0
[34] Seol JH, Jung SY, Lee HB, Kim AY, Kim EH, Min IK, et al. Outcomes in patients with pulmonary arterial hypertension underwent transcatheter closure of an atrial septal defect. J Clin Med. 2023;12(7):e2540. DOI: 10.3390/jcm12072540
[35] Zwijnenburg RD, Baggen VJ, Geenen LW, Voigt KR, Roos-Hesselink JW, van den Bosch AE. The prevalence of pulmonary arterial hypertension before and after atrial septal defect closure at adult age: A systematic review. Am Heart J. 2018;201:63–71. DOI: 10.1016/j.ahj.2018.03.020
[36] Ladouceur M, Benoit L, Radojevic J, Basquin A, Dauphin C, Hascoet S, et al. Pregnancy outcomes in patients with pulmonary arterial hypertension associated with congenital heart disease. Heart. 2017;103(4):287–92. DOI: 10.1136/heartjnl-2016-310003
[37] Shevchenko A, Krut Yu. Evaluation of risk factors and modern possibilities for prediction of preterm labour. Zaporozhye Med J. 2019;21(6):759–63. DOI: 10.14739/2310-1210.2019.6.186500
[38] Malakhova S, Syvolap V, Potapenko M. Features of cardiac remodeling depending on the mode of training session. Zaporozhye Med J. 2020;22(5):643–51. DOI: 10.14739/2310-1210.2020.5.214735
[39] Khara M, Korda I, Podilska T. Gestational diabetus mellitus and its complications, role of desynchronosis in pathogenesis (a review). Pathologia. 2023;20(2):195–2. DOI: 10.14739/2310-1237.2023.2.282626
[40] Loia N, Korchynska O, Herzanych S, Hetzko N. Characteristics of pregnancy and delivery in women with vitamin D deficiency. Zaporozhye Med J. 2020;22(4):440–45. DOI: 10.14739/2310-1210.2020.4.208347
[41] Aleksieiev O. Perspective and current state of international standards influence on prevention and treatment of diseases through the prism of developing high-quality and safe medicines. Zaporozhye Med J. 2022;24(4):448–53. DOI: 10.14739/2310-1210.2022.4.256025
[42] Zhang B, Li D, Song A, Ren Q, Cai S, Wang P, et al. Characteristics of patent foramen ovale: Analysis from a single center. Cardiol Res Pract. 2022;e5430598. DOI: 10.1155/2022/5430598
[43] Chen L, Deng W, Palacios I, Inglessis-Azuaje I, McMullin D, Zhou D, et al. Patent foramen ovale (PFO), stroke and pregnancy. J Invest Med. 2016;64(5):992–1000. DOI: 10.1136/jim-2016-000103
[44] Brida M, Chessa M, Celermajer D, Li W, Geva T, Khairy P, et al. Atrial septal defect in adulthood: A new paradigm for congenital heart disease. Eur Heart J. 2022;43(28):2660–71. DOI: 10.1093/eurheartj/ehab646
[45] Drenthen W, Boersma E, Balci A, Moons P, Roos-Hesselink JW, Mulder BJ, et al. Predictors of pregnancy complications in women with congenital heart disease. Eur Heart J. 2010;31(17):2124–32. DOI: 10.1093/eurheartj/ehq200
[46] Udholm S, Udholm L, Nyboe C, Kesmodel US, Hjortdal VE. Pregnancy outcome in women with atrial septal defect: Associated with in vitro fertilisation and pre-eclampsia. Open Heart. 2019;6(2):e001148. DOI: 10.1136/openhrt-2019-001148
[47] Roos-Hesselink J, Baris L, Johnson M, De Backer J, Otto C, Marelli A, et al. Pregnancy outcomes in women with cardiovascular disease: Evolving trends over 10 years in the ESC registry of pregnancy and cardiac disease (ROPAC). Eur Heart J. 2019;40(47):3848–55. DOI: 10.1093/eurheartj/ehz136