日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Due to improved long-term prognosis for patients with congenital heart disease (CHD), more women with CHD, including those who have undergone surgical repair or palliation for cyanotic heart disease, reach reproductive age and wish to become pregnant. Such women have a high risk of perinatal cardiovascular events, including heart failure and arrhythmia, because of the substantial changes in maternal hemodynamics. This trend is particularly pronounced in women with cyanotic heart disease, even after surgery, and there is a wide range of pathological factors that must be considered, including the underlying disease, surgical technique, presence or absence of residual lesions, and comorbidities. Therefore, to reduce the risk to mother and child, perinatal medical care tailored to each woman’s condition and severity is necessary. Furthermore, changes in women’s lifestyles have led to advanced maternal age, so the risk of obstetric complications requires greater consideration. Preconception counseling and perinatal management by a specialized medical care team are essential in high-risk cases.