Abstract：
UNASSIGNED: The European Society of Cardiology (ESC) guidelines (GL) provide indications on the mode of delivery in women with heart disease. However available data suggests that the rate of Cesarean Delivery (CD) is high and widely variable among such patients. In this study, we aimed to investigate the degree of adherence to the ESC recommendations among women delivering in four tertiary maternity services in Italy and how this affects the maternal and neonatal outcomes.
UNASSIGNED: Retrospective multicenter cohort study including pregnant women with heart disease who gave birth between January 2014 and July 2020. Composite adverse maternal outcome (CAM) was defined by the occurrence of one or more of the following: major postpartum hemorrhage, thrombo-embolic or ischemic event, de novo arrhythmia, heart failure, endocarditis, aortic dissection, need for re-surgery, sepsis, maternal death. Composite Adverse Neonatal outcome (CAN) was defined as cord arterial pH <7.00, APGAR <7 at 5 min, admission to the intensive care unit, and neonatal death. We compared the incidence of CAM and CAN between the cases with planned delivery in accordance (group \"ESC consistent\") or in disagreement (group \"ESC not consistent\") with the ESC GL.
UNASSIGNED: Overall, 175 women and 181 liveborn were included. A higher frequency of CAN was found when delivery was not planned accordingly to the ESC guidelines [(\"ESC consistent\" 9/124 (7.2%) vs \"ESC not consistent\" 13/57 (22.8%) p = 0.002 OR 3.74 (CI 95% 1.49-9.74) , while the occurrence of CAM was comparable between the two groups. At logistic regression analysis, the gestational age at delivery was the only parameter independently associated with the occurrence of CAN (p = 0.006).
UNASSIGNED: Among pregnant women with heart disease, deviating from the ESC guidelines scheduling cesarean delivery does not seem to improve maternal outcomes and it is associated with worse perinatal outcomes, mainly due to lower gestational age at birth.
UNASSIGNED: Retrospective multicenter cohort study including pregnant women with heart disease who gave birth between January 2014 and July 2020. Composite adverse maternal outcome (CAM) was defined by the occurrence of one or more of the following: major postpartum hemorrhage, thrombo-embolic or ischemic event, de novo arrhythmia, heart failure, endocarditis, aortic dissection, need for re-surgery, sepsis, maternal death. Composite Adverse Neonatal outcome (CAN) was defined as cord arterial pH <7.00, APGAR <7 at 5 min, admission to the intensive care unit, and neonatal death. We compared the incidence of CAM and CAN between the cases with planned delivery in accordance (group \"ESC consistent\") or in disagreement (group \"ESC not consistent\") with the ESC GL.
UNASSIGNED: Overall, 175 women and 181 liveborn were included. A higher frequency of CAN was found when delivery was not planned accordingly to the ESC guidelines [(\"ESC consistent\" 9/124 (7.2%) vs \"ESC not consistent\" 13/57 (22.8%) p = 0.002 OR 3.74 (CI 95% 1.49-9.74) , while the occurrence of CAM was comparable between the two groups. At logistic regression analysis, the gestational age at delivery was the only parameter independently associated with the occurrence of CAN (p = 0.006).
UNASSIGNED: Among pregnant women with heart disease, deviating from the ESC guidelines scheduling cesarean delivery does not seem to improve maternal outcomes and it is associated with worse perinatal outcomes, mainly due to lower gestational age at birth.
摘要：
UNASSIGNED：欧洲心脏病学会（ESC）指南（GL）提供了心脏病女性分娩方式的适应症。然而，现有数据表明，剖腹产（CD）的发生率很高，并且在此类患者中差异很大。在这项研究中,我们旨在调查意大利接受4项三级产妇服务的女性对ESC建议的遵守程度,以及这如何影响孕产妇和新生儿结局.
UNASSIGNED：回顾性多中心队列研究，包括2014年1月至2020年7月分娩的心脏病孕妇。复合不良产妇结局（CAM）定义为以下一种或多种情况的发生：严重产后出血，血栓栓塞或缺血事件，从头心律失常,心力衰竭,心内膜炎,主动脉夹层,需要再次手术,脓毒症,产妇死亡复合不良新生儿结局（CAN）定义为5分钟时脐带动脉pH<7.00，APGAR<7，入住重症监护室,新生儿死亡。我们比较了计划分娩（“ESC一致”组）或与ESCGL不一致（“ESC不一致”组）的病例之间CAM和CAN的发生率。
未经评估：总的来说，其中包括175名妇女和181名活体婴儿。当没有根据ESC指南计划交付时，发现CAN的频率更高[（“ESC一致”9/124（7.2％）与“ESC不一致”13/57（22.8％）p=0.002OR3.74（CI95％1.49-9.74），而CAM的发生率在两组之间具有可比性。在逻辑回归分析中，分娩时的胎龄是与CAN发生独立相关的唯一参数(p=0.006).
未经证实：在患有心脏病的孕妇中，偏离ESC指南，安排剖宫产似乎并不能改善产妇结局，并且与更糟糕的围产期结局有关。主要是由于出生时的胎龄较低。
UNASSIGNED：回顾性多中心队列研究，包括2014年1月至2020年7月分娩的心脏病孕妇。复合不良产妇结局（CAM）定义为以下一种或多种情况的发生：严重产后出血，血栓栓塞或缺血事件，从头心律失常,心力衰竭,心内膜炎,主动脉夹层,需要再次手术,脓毒症,产妇死亡复合不良新生儿结局（CAN）定义为5分钟时脐带动脉pH<7.00，APGAR<7，入住重症监护室,新生儿死亡。我们比较了计划分娩（“ESC一致”组）或与ESCGL不一致（“ESC不一致”组）的病例之间CAM和CAN的发生率。
未经评估：总的来说，其中包括175名妇女和181名活体婴儿。当没有根据ESC指南计划交付时，发现CAN的频率更高[（“ESC一致”9/124（7.2％）与“ESC不一致”13/57（22.8％）p=0.002OR3.74（CI95％1.49-9.74），而CAM的发生率在两组之间具有可比性。在逻辑回归分析中，分娩时的胎龄是与CAN发生独立相关的唯一参数(p=0.006).
未经证实：在患有心脏病的孕妇中，偏离ESC指南，安排剖宫产似乎并不能改善产妇结局，并且与更糟糕的围产期结局有关。主要是由于出生时的胎龄较低。
