Table 1.
Characteristics of pregnancies in women with HHT: A summary of 5 case series published between 1967 and 2014
| Study (Author, type) |
Women (n) / Pregnancies (n) | Live births (n) | Results | Death n (% of pregnancies) |
Known diagnosis (%) / rate of patients screened for PAVM / CAVM | Obstetrics events | Route of delivery V D (%) / C S (%) |
|---|---|---|---|---|---|---|---|
|
Goodman et al. 1967 Retrospective |
40 / 97 + 80/213 controls |
78 | no statistically significant difference between the 2 groups (HHT and control) | NA | 100 / - / - |
Miscarriage 14.4 vs 10% Abnormal outcome 50 vs 42% Prematurity 9.4 vs 10.3% Stillbirth 3.1 vs 2.6% |
NA |
|
Shovlin et al. 1995 Retrospective |
47/161 | NA |
11 severe events (6.8% of pregnancies) PAVM shunt deterioration n = 6 Cerebro vascular accident n = 3 Fatal Pulmonary hemorrhage n = 2 10/11 events in the « PAVM + » group |
3 (1.9) | 100 / - / - |
No Significant difference in the Miscarriage rate between the « PAVM + » and « PAVM – » group |
NA |
|
Shovlin et al. 2008 Prospective+retrospective |
199/484 | NA |
13 severe events (2.7% of pregnancies) Myocardial infarction n = 1 (died) Cerebro vascular accident n = 6 (2 died / 2 ischaemic, 3 haemorrhagic, 1 NA) Pulmonary hemorrhage n = 6 (2 died) |
5 (1) | 26 / - / - | NA | |
|
Wain et al. 2012 Retrospective |
226/560 | 457 | NA | NA | 100 / - / - |
T1 Miscarriage 14.3% Preeclampsia 0.6% PPH 6.2% Prematurity 13.8% LBW 10.7% |
73.5 / 20.6 |
|
De Gussem et al. 2014 Retrospective |
87 / 244 | 185 |
15 severe events (6.1% of pregnancies) Heart failure n = 1 Hemothorax n = 4 (4 undiagnosed PAVMS) Hemoptysis n = 2 Transient Ischaemic attack n = 2 Post partum: Deep veinous thrombosis n = 1 Pulmonary embolism n = 1 Myocardial ischemia n = 2 Intracranial hemorrhage n = 1 Hemothorax n = 1 |
NA | 100 / 13 / 17 |
Miscarriage 20% Gestational hypertension 2.7% Preeclampsia 7% Eclampsia 0.5% Diabetes 3.2% PPH 2% Prematurity 12% |
70 / 30 |
| Total | 599 / 1546 | 720 |
Legends: VD Vaginal delivery, CS Cesarean section, PAVM Pulmonary arteriovenous malformation, CAVM Cerebral arteriovenous malformation, LB Live birth, PP Post partum, PPH Post partum hemorrhage, LBW Low-birth weight, NA Data Not Available