{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:44:28Z","timestamp":1787499868507,"version":"build-2736575974"},"reference-count":28,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1998,11,30]]},"published-print":{"date-parts":[[1999,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To evaluate the outcome of pregnancy in women with congenital shunt lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING<\/jats:title>\n                    <jats:p>Retrospective study in a tertiary care centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Pregnancy history was obtained by a standardised questionnaire and medical records were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PATIENTS<\/jats:title>\n                    <jats:p>175 women were identified, at a mean (SD) age of 42 (14) years. Pregnancies occurred in 126 women: 50 with an atrial septal defect, 22 with a ventricular septal defect, 22 with an atrioventricular septal defect, 19 with tetralogy of Fallot, and 13 with other complex shunt lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      309 pregnancies were reported by 126 woman (2.5 (1.6) pregnancies per woman). The shortening fraction of the systemic ventricle was 40 (8)%, and 98% were in New York Heart Association class I\u2013II at last follow up. Spontaneous abortions occurred in 17% of pregnancies (abortion rate, 0.4 (0.9) per woman). Gestational age of the 241 newborn infants was 8.8 (0.8) months. There were no maternal deaths related to pregnancy. Pre-eclampsia and embolic events were observed in 1.3% and 0.6%, respectively of all pregnancies. Women with complex shunt lesions more often underwent caesarean section (70%\n                      <jats:italic>v<\/jats:italic>\n                      15\u201330%, p\u2009=\u20090.005) and gave birth to smaller babies for equivalent gestation (2577 (671) g\n                      <jats:italic>v<\/jats:italic>\n                      3016 (572) to 3207 (610) g, p\u2009&lt;\u20090.05). The recurrence risk of congenital heart disease was 2.5%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The outcome of pregnancy is favourable in women with congenital shunt lesions if their functional class and their systolic ventricular function are good. Such patients can be reassured.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/hrt.81.3.271","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"271-275","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Outcome of pregnancy in women with congenital shunt lesions"],"prefix":"10.1136","volume":"81","author":[{"given":"M","family":"Zuber","sequence":"first","affiliation":[{"name":"Division of Echocardiography, University Hospital, Raemistrasse 100, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Gautschi","sequence":"additional","affiliation":[{"name":"Division of Echocardiography, University Hospital, Raemistrasse 100, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Oechslin","sequence":"additional","affiliation":[{"name":"Division of Echocardiography, University Hospital, Raemistrasse 100, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Widmer","sequence":"additional","affiliation":[{"name":"Division of Echocardiography, University Hospital, Raemistrasse 100, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Kiowski","sequence":"additional","affiliation":[{"name":"Division of Echocardiography, University Hospital, Raemistrasse 100, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Jenni","sequence":"additional","affiliation":[{"name":"Division of Echocardiography, University Hospital, Raemistrasse 100, CH-8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1999,3,1]]},"reference":[{"key":"2025101800451497000_81.3.271.1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90583-U"},{"key":"2025101800451497000_81.3.271.2","doi-asserted-by":"crossref","first-page":"445","DOI":"10.7326\/0003-4819-76-3-112-6-445","article-title":"Pregnancy and congenital heart disease.","volume":"112","author":"Pitkin","year":"1990","journal-title":"Ann Intern Med"},{"key":"2025101800451497000_81.3.271.3","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.56.5.395"},{"key":"2025101800451497000_81.3.271.4","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(92)90034-W"},{"key":"2025101800451497000_81.3.271.5","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1056\/NEJM198508013130506","article-title":"Management of medical problems in pregnancy\u2014severe cardiac disease.","volume":"313","author":"Sullivan","year":"1985","journal-title":"N Engl J Med"},{"key":"2025101800451497000_81.3.271.6","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.9.2789"},{"key":"2025101800451497000_81.3.271.7","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.6.2673"},{"key":"2025101800451497000_81.3.271.8","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.61.2.167"},{"key":"2025101800451497000_81.3.271.9","unstructured":"Bundesamt fuer Statistik, 1997 (1997) Lebengeborene Kinder 1950\u20131995. 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