Late Referral of Eisenmenger Syndrome in Pregnancy at Dr. Soetomo Hospital Surabaya

Authors

  • Amira Ali Abdat Resident of Obstetric and gynaecology airlannga university Soetomo hospital
  • Muhammad Yusuf Universitas Airlangga

Keywords:

Keywords : Eisenmenger, pregnancy, late referral

Abstract

Background: Pregnancy with Eisenmenger syndrome is an obstetric problem which numbers keep rising every year. The cases require specific,decisive,and multidisciplinary approach.The unavailability of accurate diagnostic procedures, as well as the national consensus that has not been agreed on, all contributes to the increasing number of late referral that cause morbidity and the high risk of mortality. Purpose:  To know number and cause of late referral cases with Eisenmenger syndrome at Dr. Soetomo General Hospital, Surabaya in 2018-2019. Methods: Retrospective study by using medical records data of Dr. Soetomo General Hospital, Surabaya on January 2018- December 2019. Result: There are 18 cases of Eisenmenger syndrome from January 2018 to December 2019. Approximately 3 cases are timely referral while 15 cases are late referral cases. From those 15 late referral cases, about 12 cases (80%) are pregnant. Based on the risk factors, 73% of the patients have a congenital heart disease (Atrial septal defect) and severe pulmonary hypertension. In the postpartum referral cases group, 3 cases were referred because of suspected heart disease postpartum. Nearly all of the late referred cases have a bad prognosis those maternal deaths. There were 7 maternal deaths caused by cardiogenic shock. Regarding the source of referral, the majority of referred pregnant patient comes from out of Surabaya (73%), while for the postpartum patient, 13 % was referred from out of Surabaya.  According to the referral types, the majority of the late referral cases are emergency referral (73%), as for the postpartum referral, 20% are emergency referral. Conclusion: The number of late referral in Eisenmenger syndrome in Dr. Soetomo general hospital is still high. Further socialization and trainings regarding the early detection and management of Eisenmenger syndrome is still very much needed.

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References

Ashrafi, R., & Curtis, S. L. (2017). Heart Disease and Pregnancy. Cardiology and Therapy, 6(2), 157–173. https://doi.org/10.1007/s40119-017-0096-4

Brennan K, Hatch D. 2018. Eisenmenger syndrome. In Consult in Obstetric Anesthesiology (pp.185-187). Switzerland : Springer Nature

Cunningham F, Leveno G,Bloom KJ, Spong L, Dashe J, Sheffield JS. 2014.Congenital heart disease. In William Obstetrics (24th edition,pp. 973-999).USA:Mc Graw Hill.

Conobbio MM, Warnes CA,Aboulhosn J.2017. Management of pregnancy with complex congenital heart disease: a scientific statement for healthcare professional from the American Heart Association. 135:e50-87

Duan R, Xu X, Wang X, Yu H, You Y, Liu X, Xing A, Zhou R, Xi M. 2016. Pregnancy outcome in women with Eisenmenger’s syndrome : A case series from west China. BMC Pregnancy Childbirth ; 16 : 356 W.,

Easterling T, Stout K. 2012. Heart Disease. Obstetric Normal and Problem Pregnancies 6th ed. Philadelphia, Elsevier-Saunders; 36:825-850

Galie N, Humbert M, Vachiery JL. 2015. ESC Guidelines for the diagnosis and treatment of pulmonary hypertension: The Join Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology.Eur Heart J;37:67-119

James, P. R. (2019). The importance of pre-pregnancy counselling in cardiac disease. 1–17. https://doi.org/10.5837/bjc.2014.004

Karelkina E, Irtyuga O, Kokonina Y, Yakubov A, Li O, Mazurok V, Moiseeva O. 2019. The pregnancy outcomes and delivery in women with Eisenmenger’s syndrome,

Katsurahgi S, Kamiya C, Tamanaka K, neki R, Iwanaga N, Miyoshi T, Horiuchi C. 2019. Maternal outcome in pregnancy complicated with Eisenmenger syndrome. 1–5.

Pieper. 2011. Pre- pregnancy Risk Assesment and Counselling of The Cardiac patient. Neth Heart journal, Volume 19, pp: 477-481

Rathod S, Samal SK. 2014. Successful pregnancy outcome in a case of Eisenmenger syndrome: a rare report. J Clin Diagn Res. 8(10):0D08-9.

Regitz-Zagrosek V,Roos-Hesselink JW, Bauersachs J. 2018. ESC Guidelines for the managemet of cardiovascular disease during pregnancy. Eur Heart J.39;3165-241

Scott, N. S. (2019). Management Of Cardiovascular Disease During Pregnancy.1–6

Siu SC.,Balint OH, Mason J. 2010. Cardiac outcomes after pregnancy in woman with congenital heart disease. Heart: 96: 1656 - 1661

Stout KK, Daniels C.J, Aboulhosn JA. 2018 .AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease : A Report of the American College of cardiology/American Heart Association Task Force on Clinical Practice Guidelines J Am Coll Cardiol; 73:e81

Warnes, CA. 2019. Pregnancy and Delivery in Women With Congenital Heart Disease Preconception Counseling. 1–14

WHO. 2016. Guidelines Approved by the Guidelines Review Committee: WHO recommendations on antenatal care for a positive pregnancy,Geneva:World Heath Organization.

Published

2020-09-01

How to Cite

Ali Abdat, A., & Yusuf, M. (2020). Late Referral of Eisenmenger Syndrome in Pregnancy at Dr. Soetomo Hospital Surabaya. International Islamic Medical Journal, 1(2), 43-49. Retrieved from https://journal2.unusa.ac.id/index.php/IIMJ/article/view/1588

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Articles