Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-28T02:29:55.920Z Has data issue: false hasContentIssue false

Fatal outcome of pregnancy in the Eisenmenger syndrome

Published online by Cambridge University Press:  19 August 2008

Silvia Brach-Prever
Affiliation:
Grown-Up Congenital Heart Unit, Royal Brompton & National Heart Hospital, London
Mary Sheppard
Affiliation:
Department of Pathology, Royal Brompton & National Heart Hospital, London
Jane Somerville*
Affiliation:
Grown-Up Congenital Heart Unit, Royal Brompton & National Heart Hospital, London
*
Dr. Jane Somerville, GUCH Unit, Royal Brompton & National Heart HospitalSydney Street, London, SW3 6NP. Tel: 0171 351 8601; Fax: 0171 351 8201

Abstract

A mildly symptomatic 28-year-old women with Eisenmenger syndrome became pregnant against advice, and presented at 17 weeks insisting on continuing the pregnancy. She underwent an emergency Caesarean section for pre-eclampsia at 26 weeks, delivering a live 620 g boy, who survived to leave the hospital. In the post-partum period, she presented increasing hypoxemia, despite treatment with noradrenaline, nitric oxide and prostacyclin. She died 2 weeks after delivery from pulmonary haemorrhage. Necropsy showed histological signs of severe pulmonary vascular disease, with evidence of diffuse fibrinoid necrosis, vasculitis and haemorrhage.

Type
Clinico-Pathological Correlation
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Wood, P. The Eisenmenger syndrome. Br Med J 1958; 2: 701755.CrossRefGoogle ScholarPubMed
2.Heath, D, Edwards, JE. The pathology of hypertensive pulmonary vascular disease Circulation 1958; 18: 533547.CrossRefGoogle ScholarPubMed
3.Gleicher, N, Midwall, J, Hochberger, D, Jaffin, H. Eisenmenger's syndrome and pregnancy. Obstet Gynecol Surv 1979; 34: 721741.CrossRefGoogle Scholar
4.Shime, J, Mocarski, EJM, Hastings, D, Webb, GD, McLaughlin, PR. Congenital heart disease in pregnancy: short- and long- term complications Am J Obstet Gynecol 1987; 156: 313322.CrossRefGoogle Scholar
5.Avila, WS, Grinberg, M, Snitcowsky, R, Faccioli, R, Da Luz, PL, Bellotti, G, Pileggi, F. Maternal and fetal outcome in pregnant women with Eisenmenger's syndrome. Eur Heart J 1995; 16: 460464.CrossRefGoogle ScholarPubMed
6.Naeye, RL, Hagstrom, JW, Talmadge, BA. Postpartum death with maternal congenital heart disease. Circulation 1967; 36: 304312.CrossRefGoogle ScholarPubMed
7.Jewett, JF. Pulmonary hypertension and pre-eclampsia. N Engl J Med 1979; 301: 10631064.CrossRefGoogle ScholarPubMed