{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T11:55:02Z","timestamp":1792151702547,"version":"4.4.0"},"reference-count":30,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006484","name":"Vifor Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006484","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","award":["2009-2018"],"award-info":[{"award-number":["2009-2018"]}],"id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011010","name":"Zabawas Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011010","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100011725","name":"Servier","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017647","name":"ResMed","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017647","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","award":["2014-2021"],"award-info":[{"award-number":["2014-2021"]}],"id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","award":["2009-2018"],"award-info":[{"award-number":["2009-2018"]}],"id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Abbott","award":["2011-2021"],"award-info":[{"award-number":["2011-2021"]}]},{"name":"ESC EORP"},{"DOI":"10.13039\/100004334","name":"Merck & Co.","doi-asserted-by":"crossref","award":["2011-2014"],"award-info":[{"award-number":["2011-2014"]}],"id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008792","name":"Novartis Pharma","doi-asserted-by":"publisher","award":["2014-2020"],"award-info":[{"award-number":["2014-2020"]}],"id":[{"id":"10.13039\/100008792","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Menarini"},{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","award":["2009-2019"],"award-info":[{"award-number":["2009-2019"]}],"id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Boston Scientific","award":["2009-2012"],"award-info":[{"award-number":["2009-2012"]}]},{"name":"MSD-Merck & Co"},{"DOI":"10.13039\/501100022274","name":"Daiichi Sankyo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100022274","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Europe GmbH","award":["2011-2020"],"award-info":[{"award-number":["2011-2020"]}]},{"name":"The Bristol Myers Squibb"},{"name":"Pfizer Alliance","award":["2011-2019"],"award-info":[{"award-number":["2011-2019"]}]},{"name":"De Hoop Foundation"},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","award":["2014-2017"],"award-info":[{"award-number":["2014-2017"]}],"id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Gedeon Richter Plc"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,7,22]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Ebstein\u2019s anomaly is a rare congenital cardiac condition and data regarding pregnancy outcomes in this patient group are scarce. We evaluated the maternal and perinatal risks of pregnancy in 81\u2009women with Ebstein\u2019s anomaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Registry of Pregnancy and Cardiac disease is a prospective global registry of pregnancies in women with structural cardiac disease. Pregnancy outcomes in women with Ebstein\u2019s anomaly were examined. The primary outcome was the occurrence of a major adverse cardiac event (MACE) defined as maternal mortality, heart failure, arrhythmia, thromboembolic event or endocarditis. Secondary endpoints were obstetric and perinatal outcomes and the influence of pregnancy on tricuspid valve regurgitation as well as right atrial and ventricular dimensions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the 81\u2009women with Ebstein\u2019s anomaly (mean age 29.7\u00b16.1 years, 46.9% nulliparous), MACE occurred in 8 (9.9%) pregnancies, mostly heart failure (n=6). There were no maternal deaths. Prepregnancy signs of heart failure were predictive for MACE. Almost half of the women were delivered by caesarean section (45.7%) and preterm delivery occurred in 24.7%. Neonatal mortality was 2.5% and 4.9% of the infants had congenital heart disease. In the subgroup in which prepregnancy and postpregnancy data were available, there was no difference in tricuspid valve regurgitation grade or right atrial and ventricular dimensions before and after pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most women with Ebstein\u2019s anomaly tolerate pregnancy well, but women with prepregnancy signs of heart failure are at higher risk for MACE during pregnancy and should be counselled accordingly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002406","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T13:41:31Z","timestamp":1691415691000},"page":"e002406","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Pregnancy outcomes in women with Ebstein\u2019s anomaly: data from the Registry of Pregnancy And Cardiac disease (ROPAC)"],"prefix":"10.1136","volume":"10","author":[{"given":"Johanna A","family":"van der Zande","sequence":"first","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands"},{"name":"Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oktay","family":"Tutarel","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6741-2603","authenticated-orcid":false,"given":"Karishma P","family":"Ramlakhan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemien E","family":"van der Bosch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Bordese","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology and Congenital Heart Disease, Regina Margherita Children's Hospital, Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvin","family":"Zengin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Hamburg-Eppendorf University Heart & Vascular Center, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"de 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