CARDIOVASCULAR RISK FACTORS AND COMPLICATIONS IN PREGNANCY IN WOMEN WITH CONGENITAL HEART DISEASES

Abstract

Introduction: Women with congenital heart disease face elevated risks during pregnancy due to the complexities and challenges associated with their pre-existing cardiac condition. The physiological changes of pregnancy, including increased blood volume and additional burden on the cardiovascular system, can aggravate compromised cardiac function and lead to serious complications. These patients are subject to a range of complications, such as heart failure, arrhythmias, and pulmonary hypertension, which can negatively impact both maternal and fetal health. Objective: To examine the risk factors and cardiovascular complications associated with pregnancy in women with congenital heart disease, with the aim of better understanding the challenges faced by these patients and identifying best practices for effective management. Methodology: The methodology adopted was based on the PRISMA checklist and included searching databases such as PubMed, Scielo, and Web of Science, using five descriptors: "congenital heart disease", "pregnancy", "cardiovascular complications", "cardiovascular risk", and "gestation in heart disease". Inclusion criteria were: articles addressing pregnant women with congenital heart disease, publications from the last ten years, and studies describing specific cardiovascular complications. Exclusion criteria were: articles focused on acquired heart disease, studies not published in English, and research that does not address the context of pregnancy. Results: The results highlighted that women with congenital heart disease have a significantly increased risk of complications during pregnancy, including exacerbation of heart disease symptoms, need for surgical intervention, and increased maternal and fetal mortality rates. The analysis revealed that the presence of complex heart diseases, such as atrial septal defect and coarctation of the aorta, is associated with greater challenges during pregnancy. Furthermore, appropriate management of these complications often requires a multidisciplinary team to optimize patient management and follow-up. Conclusion: The review highlighted that pregnancy management in women with congenital heart disease is multifaceted and requires careful risk assessment and a personalized approach. Early identification of complications and coordination between specialists are crucial to improving maternal and fetal outcomes.