Table 4.
Individual characteristics of nonsurvivors among pregnant patients with CHD-PH.
| No | Congenital defect | Age at pregnancy | Saturation in admission | TTE | WHO class | Pregnancy duration /termination | Mode of delivery | Mode of anesthesia | Obstetric and cardiac events | Mode of death | Time of death |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | ASD II, Eisenmenger Syndrome | 33 | 89 | RVSP: 126 mmHg TAPSE: 18 mm LVEF: 78% | II | 31/31 weeks’ gestation | Emergency caesarean section | ASA IVE, general anesthesia, intubation | Abruptio placentae, IUFD, HELLP syndrome, severe preeclampsia | Respiratory failure, bradycardia–PEA | 24 h post emergency caesarean section |
| 2 | ASD II, Eisenmenger Syndrome | 28 | 70 | RVSP: 106 mmHg TAPSE: 16 mm LVEF: 29% | IV | 30/30 weeks’ gestation | Induced vaginal delivery | Spinal anesthesia | Sepsis, severe desaturation, bradypnea–apnea | Severe desaturation, PH crisis, bradycardia–PEA | 11 days postpartum |
| 3 | ASD II, Eisenmenger syndrome | 32 | 88 | RVSP: 129 mmHg TAPSE: 22 mm LVEF: 93% | III | 28/28 weeks’ gestation | Emergency caesarean section | ASA IIIE, general anesthesia, intubation | Total placenta previa, desaturation | Severe desaturation, cardiogenic shock, PH crisis, bradycardia–PEA | 24 h post emergency caesarean section |
| 4 | ASD II, severe PH | 26 | 94 | RVSP: 163 mmHg TAPSE: 18 mm LVEF: 63% | III | 34/34 weeks’ gestation | Elective caesarean section | Spinal anesthesia | Sepsis, severe pneumonia | Respiratory failure, bradycardia–PEA | 6 days post elective caesarean section |
| 5 | ASD II, Eisenmenger syndrome | 22 | 85 | RVSP: 78 mmHg TAPSE: 20 mm LVEF: 72% | III | 32/32 weeks’ gestation | Emergency caesarean section | ASA IIIE, general anesthesia, intubation | Desaturation, cardiogenic shock | Severe desaturation, cardiogenic shock, PH crisis, bradycardia–PEA | 24 h post emergency caesarean section |
| 6 | ASD II, Eisenmenger syndrome | 28 | 90 | RVSP: 119 mmHg TAPSE: 18 mm LVEF: 66% | IV | 32/32 weeks’ gestation | Emergency caesarean section | ASA IIIE, general anesthesia, intubation | Desaturation, cardiogenic shock | Severe desaturation, cardiogenic shock, PH crisis, bradycardia–PEA | 24 h post emergency caesarean section |
ASA: American Society of Anesthesiologists; ASD: atrial septal defect; CHD-PH: PH associated with congenital heart disease; LVEF: left ventricle ejection fraction; PEA: pulseless electrical activity; RVSP: right ventricle systolic pressure; TAPSE: tricuspid annular plane systolic excursion; TTE: transthoracic echocardiography.