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Attitudes and perceptions of pregnant women with CHD: results of a single-site survey

Published online by Cambridge University Press:  18 April 2017

Aarthi Sabanayagam ,
David Briston  and
Ali N. Zaidi
Aarthi Sabanayagam
Affiliation:
Montefiore Einstein Center for Heart & Vascular Care, Albert Einstein College of Medicine, Bronx, NY, United States of America
David Briston
Affiliation:
Pediatric Heart Center, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, United States of America
Ali N. Zaidi*
Affiliation:
Montefiore Einstein Center for Heart & Vascular Care, Albert Einstein College of Medicine, Bronx, NY, United States of America Pediatric Heart Center, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, United States of America Montefiore Adult Congenital Heart Disease Program (MAtCH), Montefiore Einstein Center for Heart & Vascular Care, Albert Einstein College of Medicine, Bronx, New York, United States of America
*
Correspondence to: A. N. Zaidi, MD, Director – Montefiore Adult Congenital Heart Disease Program (MAtCH), Division of Cardiovascular Disease, Montefiore Heart and Vascular Care Institute, The Children’s Hospital at Montefiore, Assistant Professor Internal Medicine and Pediatrics, Albert Einstein College of Medicine, 111 East 210th Street, NY 10467, United States of America. Tel: +1 718 920 5882; Fax: +1 718 654 6264; E-mail: azaidi@montefiore.org
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Abstract

Introduction

CHD occurs in about 1% of the United States population, and is now the most common cardiac condition affecting women during pregnancy.

Methods

An anonymous, single-site, cross-sectional, 50-question survey was performed at a national Adult Congenital Heart Disease conference to assess the level of knowledge, attitudes, and perceptions regarding cardiac care during pregnancy in women with CHD.

Results

A total of 77 women completed the survey. Among them, 50% (n=39) had moderate and 38% (n=29) had severely complex disease; 30% (n=23) of women were told that pregnancy was contraindicated given their underlying cardiac condition. Almost two-thirds (n=50) report being categorised as high risk for adverse cardiovascular events. During pregnancy, 84% (n=65) preferred their cardiologist to have trained in adult CHD, 44% (n=34) were satisfied with adult cardiologists, and 36% (n=28) with paediatric cardiologists. Only 48% (n=37) were aware that a fetal echocardiogram was indicated. Only 35% (n=27) discussed modes of delivery with their providers, and 70% (n=54) preferred their prenatal cardiology visits at an adult hospital. Up to 85% (n=64) of them had discussed contraception with their cardiologists, and 72% (n=56) felt they needed high-risk maternal–fetal medicine to be involved with their care.

Conclusions

Despite seeking medical care, these pregnant women did not have a full understanding of their condition and their cardiovascular risk during pregnancy. On the basis of these results, further efforts are needed to improve the knowledge, attitudes, and perceptions of women with CHD in relation to their cardiac and obstetric management during pregnancy.

Keywords

Pregnancycongenital heart diseasewomenperception
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 7 , September 2017 , pp. 1257 - 1264
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Copyright
© Cambridge University Press 2017 

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References

1. Warnes, CA, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008; 52: e143–e263.CrossRefGoogle Scholar
2. Williams, WG, Webb, GD. The emerging adult population with congenital heart disease. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2000; 3: 227–233.Google Scholar
3. Mazor Dray, E, Marelli, AJ. Adult congenital heart disease: scope of the problem. Cardiol Clin 2015; 33: 503–512.CrossRefGoogle ScholarPubMed
4. Webb, G, et al. The care of adults with congenital heart disease across the globe: Current assessment and future perspective: a position statement from the International Society for Adult Congenital Heart Disease (ISACHD). Int J Cardiol 2015; 195: 326–333.Google Scholar
5. Wacker-Gussmann, A, Thriemer, M, Yigitbasi, M, Berger, F, Nagdyman, . Women with congenital heart disease: long-term outcomes after pregnancy. Clin Res Cardiol 2013; 102: 215–222.Google Scholar
6. Warnes, CA. Pregnancy and delivery in women with congenital heart disease. Circ J 2015; 79: 1416–1421.CrossRefGoogle ScholarPubMed
7. Khairy, P, Ouyang, DW, Fernandes, SM, Lee-Parritz, A, Economy, KE. Pregnancy outcomes in women with congenital heart disease. Circulation 2006; 113: 517–524.Google Scholar
8. Stout, K. Pregnancy in women with congenital heart disease: the importance of evaluation and counselling. Heart 2005; 91: 713–714.Google Scholar
9. Heery, E, Sheehan, AM, While, AE, Coyne, I, Landzberg, MJ. Experiences and outcomes of transition from pediatric to adult health care services for young people with congenital heart disease: a systematic review. Congenit Heart Dis 2015; 10: 413–427.CrossRefGoogle ScholarPubMed
10. Lindley, KJ, Madden, T, Cahill, A, Ludbrrok, P, Billadello, JJ. Contraceptive use and unintended pregnancy in women with congenital heart disease. Obstet Gynecol 2015; 126: 363–369.Google Scholar
11. Lindley, KJ, Conner, SN, Cahill, AG, Madden, T. Contraception and pregnancy planning in women with congenital heart disease. Curr Treat Options Cardiovasc Med 2015; 17: 50.Google Scholar
12. Kovacs, AH, Harrison, JL, Colman, JM, Sermer, M, Siu, SC, Silversides, CK. Pregnancy and contraception in congenital heart disease: what women are not told. J Am Coll Cardiol 2008; 52: 577–578.CrossRefGoogle Scholar
13. Kafka, H, Johnson, MR, Gatzoulis, MA. The team approach to pregnancy and congenital heart disease. Cardiol Clin 2006; 24: 587–605; vi.CrossRefGoogle Scholar
14. Opotowsky, AR, Siddiqi, OK, D'Souza, B, Webb, G, Fernandes, SM, Landzberg, MJ. Maternal cardiovascular events during childbirth among women with congenital heart disease. Heart 2012; 98: 145–151.Google Scholar
15. Kogon, BE, et al. Adult congenital heart surgery: adult or pediatric facility? Adult or pediatric surgeon? Ann Thorac Surg 2009; 87: 833–840.Google Scholar
16. Ngu, K, Hay, M, Menahem, S. Case studies of the perceptions of women with high risk congenital heart disease successfully completing a pregnancy. Heart Lung Circ 2014; 23: 811–817.Google Scholar
17. Ngu, K, Hay, M, Menahem, S. Perceptions and motivations of an Australian cohort of women with or without congenital heart disease proceeding to pregnancy. Int J Gynaecol Obstet 2014; 126: 252–255.CrossRefGoogle ScholarPubMed