Cardiovascular diseases during pregnancy in the cardioscreening program
AbstractCardiovascular diseases (CVD) remain the leading cause of increased maternal morbidity and mortality. Since 2010, the Republic of Tatarstan has implemented a Cardiac Screening Program.
Aim – to study the outcomes of pregnancy and childbirth in women with cardiovascular pathology included in the cardiology-screening program.
Material and methods. A retrospective study included 185 residents of the Republic of Tatarstan. The main group consisted of 155 pregnant women with cardiovascular system pathology, while the control group consisted of 30 pregnant women without cardiac diseases.
Results. Cardiac rhythm disorders and conduction abnormalities were the most common, occurring in 27.1% of cases. Congenital heart defects accounted for 16.1%. In 47% of the women, CVD was diagnosed for the first time during early pregnancy. The study of pregnant women showed that the degree of perinatal risk at registration was significantly higher in women with CVD. The inpatient (21.9%) and outpatient treatment along with monitoring by a cardiologist at an expert level allowed for a pregnancy and childbirth with minimal complications. In one case, intrauterine fetal death was observed. Seventy percent of women gave birth through natural delivery. It should be noted that there was a higher frequency of hypotonic hemorrhages in women with CVD. No significant differences were found in newborn outcomes, except for the Apgar score at 5 minutes of life.
Conclusion. According to the results of the study, both quantitative and qualitative indicators of the course of pregnancy and childbirth outcomes in pregnant women with cardiac pathology do not differ significantly from those of healthy pregnant women in the case of early diagnosis and timely initiation of therapy for CVD. The currently active Cardiology Screening Program is highly effective and helps to minimize complications during pregnancy and childbirth in patients with cardiovascular system pathology.
Keywords: pregnancy; cardiovascular diseases; cardiac screening
Funding. The study had no sponsorship.
Conflict of interest. The authors declare no conflict of interest.
For citation: Shigabutdinova T.N., Gabidullina R.I., Imangulova L.I., Sharifullina K.I. Cardiovascular diseases during pregnancy in the cardioscreening program. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2025; 13 (1): 66–71. DOI: https://doi.org/10.33029/2303-9698-2025-13-1-66–71 (in Russian)
References
1. Stryuk R.I., Mravyan S.R., Petrukhin V.A. Cardiology: national guidelines. Brief edition. In: E.V. Shlyakhto (ed.). Moscow: GEOTAR-Media, 2020: 712–31. (in Russian)
2. McCoy J.A., Kim Y.Y., Nyman A., Levine L.D. Pregnancy-related cardiac outcomes among patients with congenital heart disease after formalization of a cardio-obstetrics program. Am J Obstet Gynecol MFM. 2024; 6 (4): 101335. DOI: https://doi.org/10.1016/j.ajogmf.2024.101335
3. Spiryakina Yа.G., Il’enko L.I., Evdokimov F.A. Arterial hypertension in pregnant women – diagnosis and features of therapy. Meditsinskiy alfavit [Medical Alphabet]. 2024 (24): 11–5. DOI: https://doi.org/10.33667/2078-5631-2024-24-11-15 (in Russian)
4. Alimetova S.M., Muslimova S.M. Cardiovascular diseases in women during pregnancy: features of pathogenesis and clinical course. MEDICUS Mezhdunarodniy meditsinskiy nauchniy zhurnal [MEDICUS. International Medical Scientific Journal]. 2024; 4 (58): 34–40. (in Russian)
5. Mehta L.S., Warnes C.A., Bradley E., et al. Cardiovascular considerations in caring for pregnant patients: a scientific statement from the American Heart Association American Heart Association Council on Clinical Cardiology; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; and Stroke Council. Circulation. 2020; 141 (23): e884–903. DOI: https://doi.org/10.1161/CIR.0000000000000772
6. Filippov O.S., Guseva E.V. Maternal mortality in the Russian Federation in 2019. Problemy reproduktsii [Problems of Reproduction]. 2020; 26 (6 2): 8–26. DOI: https://doi.org/10.17116/repro2020260628 (in Russian)
7. Mcilvaine S., Feinberg L., Spiel M. Cardiovascular disease in pregnancy. Neoreviews. 2021; 22 (11): e747–59. DOI: https://doi.org/10.1542/neo.22-11-e747
8. Regitz-Zagrosek V., Lundqvist C.B., Borghi C., et al. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy. Kardiol Pol. 2019; 77 (3): 245–326. DOI: https://doi.org/10.5603/KP.2019.0049
9. Afari H., Sheehan M., Reza N. Contemporary management of cardiomyopathy and heart failure in pregnancy. Cardiol Ther. 2024; 13 (1): 17–37. DOI: https://doi.org/10.1007/s40119-024-00351-y
10. Misra A., Porras M.P., Rajendran A., Contreras J., Scott N.S. Cardio-obstetrics: a focused review. Curr Cardiol Rep. 2023; 25 (9): 1065–73. DOI: https://doi.org/10.1007/s11886-023-01928-0
11. Pande S.N., Yavana Suriya J., Ganapathy S., et al. Validation of risk stratification for cardiac events in pregnant women with valvular heart disease. J Am Coll Cardiol. 2023; 82 (14): 1395–406. DOI: https://doi.org/10.1016/j. jacc.2023.07.023
12. Kopysova E.D., Tetelyutina F.K., Zhuravleva V.V., Valiev R.R. The incidence of the diseases of the circulatory system among pregnant women in the Udmurt republic in modern conditions. Zdorov’e, demografiya, ekologiya finno-ugorskikh narodov [Health, Demography, Ecology of the Finno-Ugric Peoples]. 2024; (1): 99–102. (in Russian)
13. Kravchenko E.N., Kuklina L.V., Krivchik G.V. Risk factors for fetal growth retardation. Mat’ i ditya v Kuzbasse [Mother and Child in Kuzbass]. 2020; 81 (2): 4–9. DOI: https://doi.org/10.244111/2686-7338-2020-10014 (in Russian)