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Introduction <p>The number of pregnant women with adult congenital heart disease (ACHD) is increasing, posing growing challenges for obstetric anaesthesia. This study analysed anaesthetic strategies and postoperative care in ACHD patients treated at a&#xa0;tertiary care centre.</p> Methods <p>This retrospective single-centre study included ACHD patients who received anaesthesia for delivery, caesarean section or obstetric surgery between 2004 and 2023. A&#xa0;comparison group of obstetric patients without congenital heart disease was selected based on baseline characteristics.</p> Results <p>A&#xa0;total of 391 cases were included (131 ACHD, 260 comparison group). Most patients were classified as mWHO&#xa0;I (44.2%) or&#xa0;II (23.8%), with 20.5% mWHO II–III and 11.5% mWHO III and IV. Spinal and epidural anaesthesia were used more frequently in lower mWHO classes (<i>p</i> = 0.017). All mWHO&#xa0;IV patients required general anaesthesia provided by ACHD-experienced anaesthetists. ACHD patients more frequently required postoperative ICU or IMCU care (6.6% vs.&#xa0;1.6%, <i>p</i> = 0.02; 13.9% vs.&#xa0;3.7%, <i>p</i> &lt; 0.001). Anaesthesiologic complication rates were low in both groups.</p> Conclusion <p>Obstetric anaesthesia was feasible with low complication rates, even in severe ACHD, when management was individualised and interdisciplinary. All anaesthetic procedures proved to be feasible when adapted to the risk profile.</p>

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Monozentrische Kohortenanalyse des anästhesiologischen Managements von Schwangeren mit angeborenen Herzfehlern

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月7日

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  • Emmanuel Schneck,
  • Melanie Markmann,
  • Annahita Bahadori,
  • Emmanuella Iyoha,
  • Frank Oehmke,
  • Roland Axt-Fliedner,
  • Aline Wolter,
  • Monika Lüdemann,
  • Thomas S. Zajonz,
  • Matthias Müller

摘要

Introduction

The number of pregnant women with adult congenital heart disease (ACHD) is increasing, posing growing challenges for obstetric anaesthesia. This study analysed anaesthetic strategies and postoperative care in ACHD patients treated at a tertiary care centre.

Methods

This retrospective single-centre study included ACHD patients who received anaesthesia for delivery, caesarean section or obstetric surgery between 2004 and 2023. A comparison group of obstetric patients without congenital heart disease was selected based on baseline characteristics.

Results

A total of 391 cases were included (131 ACHD, 260 comparison group). Most patients were classified as mWHO I (44.2%) or II (23.8%), with 20.5% mWHO II–III and 11.5% mWHO III and IV. Spinal and epidural anaesthesia were used more frequently in lower mWHO classes (p = 0.017). All mWHO IV patients required general anaesthesia provided by ACHD-experienced anaesthetists. ACHD patients more frequently required postoperative ICU or IMCU care (6.6% vs. 1.6%, p = 0.02; 13.9% vs. 3.7%, p < 0.001). Anaesthesiologic complication rates were low in both groups.

Conclusion

Obstetric anaesthesia was feasible with low complication rates, even in severe ACHD, when management was individualised and interdisciplinary. All anaesthetic procedures proved to be feasible when adapted to the risk profile.