Pregnancy outcome and delivery in women with congenital heart disease

Purpose: Obstetric and neonatal complications are common during pregnancy in women with Congenital Heart Disease (CHD). We assessed mode of delivery and the prevalence of these complications. Methods: ZAHARA II is a national, prospective multi-center cohort study. We included 213 consecutive pregnant women with CHD and 70 healthy pregnant women (controls). We compared prevalence of obstetric and neonatal complications between women with CHD and healthy women. Results: Vaginal delivery rates were lower in women with CHD compared to healthy women (76.5% vs. 87.0% p=0.087), but did not reach statistical significance. Induction of labour was more common in women with CHD than in controls (37.1% vs. 21.4%, p=0.019) and more assisted deliveries were observed (47.9% vs. 25.7% p=0.001). Elective caesarean sections were more often performed in women with CHD (14.1% vs. 1.4% p=0.002), 36.6% for cardiac reasons. No differences were observed in hypertensive complications of pregnancy or post partum hemorrhage. Offspring death occurred in 2.8% of women with CHD versus 0% in controls. Mean pregnancy duration was 38 weeks in women with CHD compared to 39 weeks in healthy women (p