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Women with congenital heart disease are often considered to be restricted in their obstetrical life and even their marital life. Our single-centre study aimed to determine the real-life situation of these women with regard to successful family life and any pregnancy complications they may experience.
Methods
From our database of adults with congenital heart disease, 160 of 178 women completed a questionnaire and had their files reviewed. They were classified into three groups according to their pregnancy risk – “good condition” group, no pregnancy restriction; “at-risk” group, pregnancy allowed with close follow-up at a tertiary centre; and “contraindicated” group, pregnancy inadvisable.
Results
The proportion of women in a relationship was 46% with no difference between the three groups. In the groups where pregnancy was allowed, 55% of women conceived a child. The total incidence of spontaneous abortion was 21%. The rate of caesarean section was 15%. The incidence of cardiac failure was 4.7%, arrhythmia 1.2%, endocarditis 1.2%, hypertension 2.4%, and preeclampsia 1.2%. Foetal complications included prematurity and/or low birth weight (9.5%) and one foetal malformation (0.82%).
Conclusion
Women with severe congenital heart disease are willing to start a family and are successful in this enterprise. Although the complication rate during pregnancy in congenital heart disease remains high, with good monitoring these pregnancies occur without severe complications and a low rate of medical abortion or caesarean section.
The ancient period witnessed the remarkable transformation of Christianity from a persecuted minority sect into the dominant political and cultural force in the Mediterranean world. One aspect of this development was the formation of a set of discourses and practices regarding sexual, marital and familial life. If imperial legislation showed only modest influence from Christian teaching, the efforts of ecclesiastical authorities were more ambitious. Through preaching and the imposition of penitential discipline, the bishops of the fourth, fifth and sixth centuries scrutinised and attempted to regulate the sexual lives of their congregations with rigorous precision. Over time, the sexual lives of married Christians were circumscribed by numerous prescriptions. Only in the fourth century do we see the beginnings of specifically Christian liturgical practices for marriage, initially within the context of ceremonies in the family home. As marriage rituals in antiquity were notably boisterous affairs, clergy were hesitant at first to participate.
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