• Prevention of hypoxic fetal complications in pregnant women with congenital heart disease and anemia 

Prevention of hypoxic fetal complications in pregnant women with congenital heart disease and anemia 

PERINATOLOGIYA I PEDIATRIYA. 2016.2(66):43-48; doi 10.15574/PP.2016.66.43 

Prevention of hypoxic fetal complications in pregnant women with congenital heart disease and anemia 

Davydova Y., Zadorozhna T., Butenko L., Limanskaya A., Ogorodnyk A., Mokrik A.

SI «Institute of Pediatrics, Obstetrics and Gynecology NAMS Ukraine», Kyiv 

The aim of the study is — to develop a strategy of prevention of hypoxic fetal abnormalities in pregnant women with congenital heart disease, heart failure and iron deficiency anemia. 

Materials and methods. The study included 86 pregnant women with CHD and NYHA II–III. 68 women in the third trimester of pregnancy is diagnosed anemia (group I), 18 pregnant women with CHD, NYHA II–III without anemia (II group), the control group consisted of 24 pregnant women without cardiac disease, with physiological pregnancy. All pregnant with information registration consent studied the concentration of ferritin, hemoglobin level, morphological study of the placenta. All pregnant women were assigned to iron supplements, oral iron (III) hydroxide polymaltose complex (Maltofer) when hemoglobin levels above 95 g/l and the expected delivery date more than 40 days of starting treatment. When the hemoglobin level below 95 g/l of intravenously administered iron (III) hydroxide sucrose complex (Venofer) followed by transfer to oral iron (III). 

Results. In groups of pregnant I and II did not have perinatal losses, births in gestation less than 28 weeks, with a score Apgar at birth of less than 4 points. Pregnant women with cyanotic heart defects and the need for early delivery in less than 37 weeks are not included in the study. Also, there is a correlation between the degree of severity of anemia in women with CHD with HF and prematurity, and the presence of IUGR child birth asphyxia able to varying degrees (respectively, r=0.8, r=0.75 and r=0.85). 

Conclusions. Formation of fetoplacental unit in women with CHD on a background of heart failure occurs with complications associated with the presence of tissue hypoxia, as well as the possible impact on the process of oxidative stress. The development of iron deficiency anemia in this group is an additional risk factor for placental dysfunction, which is confirmed by morphometric and morphological studies of placentas. Early prevention and prompt treatment can significantly reduce the incidence of complications and improve perinatal outcomes in this group of patients. 

Key words: pregnancy, congenital heart disease, heart failure, iron deficiency anemia, ferric iron, gestational hypoxia. 


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