Аңдатпа
Abstract Funding Acknowledgements Type of funding sources: None. Background Although bradyarrhythmias may occur in pregnant patients, there are few data on their management, pregnancy course and perinatal outcomes. Purpose To evaluate the effects of bradyarrhythmias on the course and outcomes of pregnancy. Methods This single-center, prospective study included 8 cases of complete atrioventricular block in pregnant patients (Mean age of pregnant was 25.4±3.6 years, mean gestation age 17.6 ±2.4 weeks). All patients were without structural heart disease. Pregnancy course, clinical outcomes and bradyarrhythmias management were evaluated. Results Complete atrioventricular block was registered in three women prior to pregnancy (37.5%). In 5 cases (62.5%) atrioventricular block diagnosed for the first time during this gestation. All included patients had symptoms of dizziness and syncope during pregnancy. Due to hemodynamic instability pacemakers were implanted in all cases of complete atrioventricular block. Procedure-related complications were not documented. Implantation was performed with the help of echocardiographic guidance and electroanatomical mapping (Ensite Precision system) with minimal fluoroscopy. Pregnancy course in patients with bradyarrhythmias characterized by increased incidence of uterine contractile activity (n=3, 37.5%), uterine blood flow violation was in one case (12.5%). Perinatal outcomes: spontaneous vaginal delivery was in the majority of cases (n=7; 87.5%). One pregnant (12.5%) was delivered by cesarean section. One women had placental abruption and preeclampsia (12.5%). Maternal adverse cardiac events and adverse fetal outcomes were none declared. There were 8 live births (in all cases, 100%). Fetal birth weight was 3158.07±458.2 grams, 5 minute Apgar was 8.87±0.6. There were no maternal and fetal mortality. Conclusions Complete atrioventricular block, observed in patients, did not require termination of gestation. Implantation of pacemaker in cases of complete atrioventricular block can be safety performed in pregnancy and associated with benign pregnancy course and outcomes in the majority of cases.