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Mode of delivery in pregnancies complicated by major fetal congenital heart disease: a retrospective cohort study

Journal of Perinatology volume 34, pages 901–905 (2014)Cite this article

Subjects

Abstract

Objective:

To determine the mode of delivery in pregnancies complicated by complex fetal congenital heart disease (CHD).

Study Design:

Five-year retrospective cohort study at a tertiary fetal medicine center (2007 to 2011). Cases of complex fetal CHD (n=126) were compared with 45 069 non-anomalous singleton infants ⩾500 g to determine rates of emergency intrapartum cesarean section (CS), preterm delivery and induction of labor.

Result:

Intrapartum CS is significantly higher in fetal CHD than non-anomalous controls (21% vs 13.5%, odds ratio (OR) 1.7, 95% confidence interval (CI): 1.0 to 2.7; P=0.035), predominantly related to CS for non-reassuring fetal status (OR 2.2, 95% CI: 1.1 to 4.1; P=0.022). Although fetal CHD did not increase emergency CS rates in nulliparous women, CS was significantly increased in multiparous pregnancies (OR 2.4, 95% CI: 1.8 to 4.6; P=0.014). Rates of preterm delivery (OR 3.4, 95% CI: 2.0 to 5.4; P<0.0001) and induction of labor (OR 1.9, 95% CI: 1.3 to 2.9; P=0.001) were higher in the CHD cases.

Conclusion:

Emergency CS is increased in fetal CHD, attributed to a higher rate of CS for non-reassuring fetal status and seen mostly in multiparous women.

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Acknowledgements

We are grateful to Ms Fionnuala Byrne, Information Officer, National Maternity Hospital for her help with data collection and retrieval.

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Authors and Affiliations

  1. Fetal Medicine Unit, National Maternity Hospital, Dublin, Ireland

    C A Walsh, C Mulcahy, R Mahony, S Higgins, S Carroll, P McParland & F M McAuliffe

  2. UCD Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, Dublin, Ireland

    A MacTiernan, S Farrell & F M McAuliffe

  3. Department of Pediatric Cardiology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland

    C J McMahon, O Franklin & D Coleman

Authors
  1. C A Walsh
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  2. A MacTiernan
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  3. S Farrell
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  4. C Mulcahy
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  5. C J McMahon
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  6. O Franklin
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  7. D Coleman
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  8. R Mahony
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  9. S Higgins
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  10. S Carroll
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  11. P McParland
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  12. F M McAuliffe
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Corresponding author

Correspondence to F M McAuliffe.

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Competing interests

The authors declare no conflict of interest.

Additional information

This study was presented in part at the 16th Annual Meeting of the British Maternal–Fetal Medicine Society in Dublin, Ireland, April 2013.

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Walsh, C., MacTiernan, A., Farrell, S. et al. Mode of delivery in pregnancies complicated by major fetal congenital heart disease: a retrospective cohort study. J Perinatol 34, 901–905 (2014). https://doi.org/10.1038/jp.2014.104

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