688
PŮVODNÍ42522701004395143193242296315
PRÁCE75522701004489137177218
Adverse42533701004280117152176206242
obstetric68333701003876105133168195220236266
and96533701003472110
neonatal109133701003773112150185211247263
outcomes137033701003876103133171231266296
of168233701003858
pregnancy17563370100376196135173207245276313
in208633701001452
high-risk21543370100375290128153177193222256
women242633701005291151186224
with26663370100526894133
heart281533701003772107131160
disease29913370100385381117152181217
E622822701004182
|350227010018
VNITŘNÍ4268043010746106127172220280301
LÉKAŘSTVÍ748804301074185130188236280325378400
/11948043010731
Vnitř1270804301074693112140166
Lék.1456804301074083122140
2024;70(3):E4-E91615804301074487129169183224266291333354369411453481525568
/22288043010732
www.casopisvnitrnilekarstvi.cz442680430107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
Results4254654013868127179242275320373
In565482301071967
group648482301074975122170219
1,883482301074454
we9544823010765108
analyzed1078482301074189129148188226269319
191413482301074482
pregnancies1511482301075076119169217257305345364407440
in1968482301071966
172051482301074480
women,21484823010764112185229277293
with2457482301076584112160
202633482301074487
fetuses273648230107246794142425496301073478111
and557496301074189138
20715496301074487
live-born82349630107193778121150201250277326
neonates.1169496301074993142191231258301335351
In1541496301071967
group1628496301074975122171220
2,1868496301074459
there1948496301072876120147189
were21584963010765108135178
352356496301074485
pregnancies2462496301075076119169218258306347365409443
in425510301071967
31518510301074483
women,6275103010765113187232280295
with949510301076584112161
361136510301074487
fetuses125051030107236795143176220254
and1530510301074189139
341695510301074489
live-born181051030107193879122151202251278327
neonates,2163510301074993142191231259301335351
while25405103010765114133151196
two2762510301072895143
pregnancies425524301075077120170218258306347366409443
ended888524301074392141185235
in1143524301071967
miscarriages.1229524301077493125166207234261280320370414448464
The565538301074293139
most7255383010773124159190
common935538301074089165240290341
heart1296538301074894136164197
diseases1513538301074970104150192227273309
were18425383010765110139183
congenital2046538301074088139190236286306336379400
heart2466538301074894136164197
diseases2684538301074869103149191425552301073480115
(33.3%562552301072469112129176242
of827552301074874
the923552301072878124
total1069552301072876106149169
cohort),1261552301074088139189218251276291
heart1575552301074894136164197
rhythm1794552301072777118151201276
disorders2092552301074970104154183233279307343
(22.9%),2458552301072468114131175244267283
and2763552301074191142
valvular425566301074185106150201222265294
heart749566301074996138167201
diseases980566301075070106152195231277313
(20.8%).1324566301072469115132180250273289
This1643566301074395116151
was18245663010766110146
followed200056630107247496117168235281334
by2364566301075192
pulmonary24875663010750101122198249301344372418
arterial425580301074170103148177199241263
hypertension718580301074990143190219252297348383404454506
(6.3%),125458030107246987134202226242
cardiomyopathies1526580301074185113164185236312353404456500530581601648684
(4.2%),224058030107246886134203226242
and2512580301074292144
aortic2687580301074192121154176218
diseases425594301074969104150192227273308
(4.2%).75759430107246784131199222237
An5656083010753101
overview684608301074788131157201221265330
of1031608301074872
cardiac1121608301074082108156175215256
diagnoses1394608301074968108158206254288332366
in1777608301071967
groups1862608301074975122170220253
121336083010744
and2195608301074189138
223516083010744
are2412608301074168111
presented2540608301075077120154198246273315365
in425622301071967
Table509622301074277126146190
1a716622301074479
and812622301074189138
19686223010743
b,1027622301075064
respectively.1108622301072770104153198239269288329372392432444
Six156962230107415999
patients1685622301074991118137181229256290
(12.5%1993622301072363101116160225
of2235622301074872
the2324622301072776120
total2461622301072874102143162
cohort)2640622301074087135184211242265
had425636301074889138
an586636301074189
extremely698636301074483114141184257302321361
high1082636301074867116164
risk126863630107274679117
of1407636301074872
maternal15026363010774115142184211260300319
mortality18446363010774122149180222241259287330
or2197636301074774
severe2294636301073478119162188231
morbidity25486363010774122149200219268287315357
(mWHO425650301072495167224285
IV).73765030107196592106
Eleven869650301074260104145188237
patients1132650301075091118137181229256291
(22.9%)1449650301072467111126168236257
had1733650301074889138
a18976503010741
significantly1964650301073452101149168192212252294342368388428
increased2418650301071967107134177217250294345
risk278965030107264678116
of425664301074872
maternal5216643010774114142184211259300319
mortality8646643010774122149180222241259287330
or1218664301074875
severe1317664301073377118161188231
morbidity15726643010774122149199218268286314357
(mWHO1953664301072495167224285
III).2262664301071938578093
The2379664301074292136
remaining2539664301072770143184203251269317366
31425678301074483
patients529678301075092119138181229256291
(64.6%)842678301072466112127172237259
had1122678301074989139
low1282678301071968132
to1436678301072874
intermediate153267830107196794136163237281331350390417460
risk.201367830107274679117135
In2169678301071967
group2258678301074975122170220
1,2500678301074354
two2576678301072795143
patients2740678301075091119137425692301074492119153
were6016923010765109135178
on802692301074897
full92169230107247392110
anticoagulation1054692301074189116135175222263313360379420447466514562
therapy1639692301072876120147189238277
(both1939692301072474123151199
for216169230107237198
mechanical22826923010773118159207248296314355396415
valve2720692301074182101142185
prostheses;425706301075077124157186234279312357390405
11.8%85170630107437889134201
of1073706301074771
the1165706301072876120
patients).1306706301075091118137181229256291312325
In1652706301071967
group1739706301074976123171220
219807063010744
there2045706301072776120146189
was22557063010765106139
no2415706301074897
patient2532706301075092119138181230256
on2809706301074896
anticoagulation425720301074189116135175221263312360379419447465513562
therapy.1007720301072876120147188238277289
The565734301074190134
characteristics714734301074087127153194233263305330349381410428467501
of1231734301074771
both1318734301074997124171
groups1505734301074874120168216249
are1770734301074066108
shown1894734301073380127191239
in2149734301071966
Table2230734301074276125144187
2.2433734301074358
The2507734301074190133
groups2656734301074974120168216249
did425748301075070121
not574748301074999128
differ72974830107517095124169197
significantly954748301073453104154173199219261304354382402444
in1425748301072069
average1522748301074283128156199250296
age,1846748301074293139154
the2028748301072878124
percentage2180748301075197125166210260288331382428
of2635748301074975
twin2737748301072999119168
pregnancies,425762301075179123175224266316357377422457473
primipara,92676230107517999174193244287315358374
or1328762301074977
in1432762301071969
the1528762301072878124
number1679762301074998174225271299
of2005762301074974
abortions2106762301074293144172204224273323357
in2491762301071968
previous2587762301075178123165185234284318
pregnancies.425776301075077120170218258306347366409443460
The3187594301074396143
obstetric33635943010749102139170216246275297340
outcomes37365943010749100131173222300348384
are4153594301074271117
presented4302594301075181127163210262291337390
in4724594301072071
Table4827594301074481134156203
3.5063594301074562
In5158594301071971
several5261594301073582125172201245267
aspects,3047608301074175125171213244280297
they3369608301072877122163
were35576083010765109137180
significantly3763608301073352102151171195216257300349376396437
worse42256083010765114142177222
in4472608301071968
group4565608301074976124173224
1.4814608301074456
High-risk4895608301075676126175204232253286325
women52456083010765113188234283
gave3047622301074991131175
birth324562230107496997129178
significantly3445622301073453103152171196217258300349377397438
earlier3905622301074485112133152197224
than4151622301072877119168
low-risk4341622301071969134163191212245284
women.46476223010765114189234283300
They4970622301074192137178
had5170622301074890140
a53336223010741
significantly5396622301073453103304763630107486792112153195243271291331
longer3396636301071968117167211239
hospitalization,3653636301074897131180200229271290309346389417436485534550
a42216363010741
higher4280636301074867117165210237
proportion4535636301074977125175225252284303352401
of4954636301074872
deliveries5044636301074994114133174218245265309343
per5406636301074994121
Caesarean3047650301075193137171213240283324372
section3437650301073378119150169218266
(C.s.),372165030107247491125142166180
and3919650301074088138
higher4075650301074867116164209236
estimated4329650301074377106126199240268311361
blood4708650301074969118167217
loss4943650301071968101135
during5096650301074996123143191241
operative5354650301074898144304766430107276997117159203
delivery.3271664301074994114133175219247291303
All359566430107537392
patients3708664301075092120140185234262297
in4026664301071968
group4115664301074976124173223
143596643010744
underwent4424664301074897147192219288333382409
operative4854664301074899145172215243263305349
delivery.5224664301074994114133175219246290303
Operative30476783010760112158185227255275317361
vaginal3430678301074183133153202243263
delivery3715678301074994114133175219247291
using4028678301074781100149199
vacuum4249678301074183125173222296
extraction4567678301074484116143186227259278327377
was49656783010765108142
performed5129678301074995123150199227302347398
only3047692301074897117158
in3231692301071968
group3325692301074977125174224
235756923010744
(9.4%364669230107236579124189
of3862692301074872
all396169230107416080
deliveries).4067692301074994114134175220247267312346368383
Emergent44766923010742116161188237282331359
operative4861692301074899145173215243263305349
delivery5236692301074994114134175220247291
was30477063010765107140
not3205706301074897125
indicated3348706301071967117137177219247290340
for370770630107237199
any3824706301074089128
parturient.3970706301074991118150198225245290338366383
Intra-amniotic437170630107196794122164193234308356375424452471512
infection490170630107196791135177208227276325
was52447063010764106140
not5402706301074897125
detected3047720301074994123166208239283334
in3402720301071968
any3491720301074190130
case.3642720301074083117162178
The3187734301074293138
most33537343010774124159189
significant3570734301073453103152172197218259302351379
differences397773430107496994122167194239288329373408
between4413734301075096125194238284333
groups4775734301074976124174224259
were50627343010765110138182
related527273430107277191133161204256
to3047748301072875
neonatal3146748301074893143192234262304324
outcomes3493748301074897126166213288334368
(Table3884748301072470106157177222
4).412974830107446781
Newborns42337483010758103169220270298347381
of4637748301074873
mWHO47337483010774147205267
class5023748301074060101136170
III521674830107193959
and5298748301074190140
IV5461748301071966
mothers30477623010774123151200246273308
had3379762301074889140
significantly3542762301073453103152171196217258300349377397438
lower4003762301072069134179206
birth423376230107496997128178
weight44347623010765109129179228256
and4713762301074190140
length4877762301071964113163192241
and5142762301074190140
worse53057623010765114142177222
Apgar30477763010753103155196224
scores3299776301073475123151195229
(one3557776301072370120165
minute3750776301077493142191220263
and4042776301074190140
five421077630107244487131
minutes).4369776301077493142191220263298320334
In4731776301071969
group4828776301074976124173224
1,5080776301074455
there5163776301072878123150194
was53857763010765108142
Tab.42561301135093144171
1a.62361301135499127
Leading77762201073774119165183229274
cardiovascular106762201073882107151169214252296326363408426471497
diagnosis158062201074563108154200245275292321
in191862201071864
patients199862201074691117135173220245276
of229062201074568
group237462201074671115161207
12597622010741
(mWHO265462201072493164217276
III-IV)2946622010719375683104148174
mWHO334575909868136191249
class3610759098365899133167
n485075909846
Pulmonary4568790984590112180226273314343386
arterial8598790984170100142171193234255
hypertension11318790984685133176205236277324358379425472
IV35328820951758
3485388209539
Severe4569990984284125166195237
systolic7109990983375109138183205226263
dysfunction9899990984788122149195242278309330376422
of14289990984571
the15169990982874117
systemic16499990983375109138180248270306
ventricle1197299909841821281571862072442653072275100505725
IV353210020951758
34853100209539
Asymptomatic45611190985186127197244273319387429457478515
severe98711190983476117158187229
aortic123311190984186116146167204
stenosis145411190983362104150196230251285
III35361122095173451
34853112209539
Mechanical456123909866109146192234280301338380401
valvular87412390984082103144191212254283
prosthesis,117412390984676122156185231274308329363383
oral157412390984574116137
anticoagulation172712390984187116137173219260307353374416444465511558
III35361242095173451
24853124209539
Status45613590984269111140186220
after6931359098406697139168
ICD87813590982169124
implantation101913590982089136158199246274316345366412458
for149413590982571101
secondary161113590983476113158205252294323366
prevention21993135909847771191602012472762973433892383136505725
III35361362095173451
24853136209539
Moderate456147909866112160202232273302343
systolic81614790983375109138183205226263
dysfunction109514790984788122149195242278309330376422
of153414790984571
the162214790982874117
left17551479098216390121
ventricle189214790984182129157186207244265307
III35361482095173451
24853148209539
Fontan45615990984186132161203249
circulation7221599098365786123169190232260281327374
without111215990986081110157203249278
complications140615990983682150198220241277319348369414461495
III35361602095173451
14853160209539
Aortic45617190985196125156177214
aneurysm,68617190984187129176205248282350371
severe107317190983476117158187229
asymptomatic131917190984174116185233262307376417446467503
aortic183917190984186116146167204
regurgitation205917190982971118164194240262290332361382428474
III35361722095173451
14853172209539
1456184705622
–492184209540
1×54618420953780
dilated6401842095415774114138170211
cardiomyopathy,8661842095337295134151191255287327368409433474506518
1×139818420953780
severe14921842095286196129152185
mitral169218420956380103126164181
regurgitation18871842095235697138161200216239278302318358400
with23021842095557195136
pulmonary24521842095408198162202244284307343
edema,1×280918420953475109173213228261304
status31271842095285190113154181
after33221842095416187120143
Senning348018420953569110151168209249
operation374418420954081116139177200217257299
for40571842095216184
uncorrected415618420954081115154177200233267292325365
transposition45361842095234685126153192233260276299316356398
of494818420954061
the50231842095246599
great51371842095406396136160
arteries531118420954064456194209523567996130158
with6281942095567296137
global7791942095405797138179196
dysfunction98919420954174102122164205239264280320362
of136619420954060
the14411942095236499
systemic15541942095286189113145209226259
right18271942095234080122144
ventricle;198619420953367108131154170204220255269
22270194705622
–2306194209540
1×236019420953780
pulseless24541942095418298125159175209238265
ventricular273319420953467109131154171204245261302325
tachycardia30721942095236296137169202242265303320360
and344719420954081122
ventricular358319420953467109131154171204245261302325
fibrillation,1×39221942095213878102118135151192215231272313328361403
polymorphic43401942095408198131195235259300341358391
ventricular474619420953367108131154170204244261301324
tachycardia50851942095236295137168202241264303320360
(both45620420952162103126167
patients63820420954081104121155196219247
after8992042095416187120143
cardiopulmonary10572042095337295134151191233274290354394436476500535
resuscitation)16062042095235684124151184200223262285302342384403
Tab.425229301135093144171
1b.6232293011354102128
Leading779230201073774119165183229274
cardiovascular1069230201073882107151169214252296326363408426471497
diagnosis1582230201074563108154200245275292321
in1920230201071864
patients2000230201074691117135173220245276
of2292230201074568
group2376230201074671115161207
225992302010741
(mWHO2656230201072493164217276
<29482302010753
III)30182302010718375678
mWHO3313243909868136191249
class35782439098365899133167
n4838243909846
Congenital45625590984792139185228274295324366387
heart86025590984688129159189
diseases106625590984668102144185219262296
II-III13463256209517345978951123572256705623
<3471266209548
III35362662095173451
II351227620951734
I3520286209517
44841256209539
34841266209539
14841276209539
64841286209539
Asymptomatic45729790985186127197244273319387429457478515
moderate988297909868114162204234275304345
aortic135029790984086115146167204
stenosis157029790983463104151197231252286
II-III347329820951734597895112
34841298209539
Hypertrophic45730990985495143185215246275321368415436473
obstructive94630990984693127157186232269299320361402
cardiomyopathy51365309909836781071541762212903303754234644935395791943310505725
II-III347331020951734597895112
14841310209539
Severe45632190984284125166195237
aortic71032190984186116146167204
regurgitation93032190982971118164194240262290332361382428474
II-III347332220951734597895112
14841322209539
Loeys-Dietz45633390983985128168202228285306348378416
syndrome88833390983375122169199245313356
without126033390986082110157203249278
aortic155533390984086115146167204
dilatation17753339098476889131159201230251296343
II-III347333420951734597895112
14841334209539
Third-degree45634590984289110139187213262304352381423466
atrioventricular9383459098416998119165206247294322351372409455476518547
block150234590984668114151193
<3471346209548
III35363462095173451
44841346209539
Status45735790984269111140186220
after6943579098406697139168
heart87935790984688129159189
transplantation2108535790982857981451792262482893363644064354565015481632358505725
<3471358209548
III35363582095173451
14841358209539
Left45736990983982108139
ventricular61336990984182128157186207244290311353382
pseudoaneurysm31011369909847811241702172633053523944404705125466151625370505725
<3471370209548
III35363702095173451
14841370209539
Incessant45738190982168105146180214256303331
nonsustained80538190984591138172218252281323344391433481
ventricular130238190984182129157186207244290311353382
tachycardia41701381909828701061531922282702993463684092110382505725
<3471382209548
III35363822095173451
14841382209539
Symptomatic45739390984280150197226272340382410431468
ventricular94139390984182129157186207244290311353382
preexcitation134039390984776118161202237258287329358379424471
II351239420951734
34841394209539
Atrioventricular45740590985178107129174215256303331360381418464485527556
nodal103040590984692139181202
reentry124940590982870113160188217260
tachycardia61525405909828701071541932292713003473684101936406505725
II351240620951734
14841406209539
1456418705622
–492418209540
3×54641820953784
status6444182095285190114154181
after8394182095416187120143
surgery9974182095276790129163186222
for12334182095216084
tetralogy13314182095245680103142158199240273
of161841820954061
Fallot16944182095347390107147170
with18794182095557295136
severe20294182095286296130153186
residual22294182095235684100140181221238
pulmonary24814182095418298162202244285308343
regurgitation,28384182095235697138161200216240278302318359400414
1×326741820953780
hemodynamically336141820954175139180221254296336400416450489506523556
severe39314182095286196129152185
partial413141820954081104130146186203
anomalous434841820954182122186227244284325352
pulmonary47144182095408198162202244284307343
venous507141820953467109149190217
return;5302418209523564564282095236487129142
2613428705622
–649428209540
for7034282095216184
heart80142820954276117140165
failure981428209520597693133156189
due118542820954081115
to131442820952463
hypertrophic139142820954173114149172198221260301343359393
cardiomyopathy;17984282095337396135152192256288328369410433474506521
32333428705622
–2369428209540
after24234282095416187120143
mitral258142820956380103126164181
valvuloplasty27764282095347390124165182222263280320347371406
for31974282095206083
infective32954282095165778111145170186220253
endocarditis;356342820953475116156190230253292309332348375388
43965428705622
–4001428209540
status40554282095285290114155181
after42514282095406086119142
radiofrequency440842820952361102118159180203236277318352394427462
catheter48844282095337396137172195228251
ablation51504282095408198138161178218260
of542442820954061
the4564382095236599
substrate;56943820952867108135159182220243276290
5874438705622
–910438209540
status9644382095285290114155181
after11604382095406086119142
septal131743820952861102125164181
myectomy151243820956496129163188227291323
and184943820954182123
mitral198643820956480103126165181
valvuloplasty;21824382095337389123164181221263279320347371406420
62617438705622
–2653438209540
with27074382095567295137
extreme28584382095346894117150213248
tachycardia31204382095236296137169202242265304320360
Tab.3047466901135093144171
232454669011354
Characteristics3326467801074894139165208245273309335353383409427464496
of3838467801074568
pregnancies3922467801074571108154200245291328346384416
Group383748160985383129175223
14077481609842
(n384249160982468
=3927491609848
19399149160984383
)4090491609824
Group445748160985383129175223
24697481609842
(n447049160982468
=4555491609848
35)461949160984385108
p5194486609847
Age307950360985197139
(years)323550360982465106148177211234
31.938315039095397484122
±3971503909547
3.740365039095395391
30.344455039095397892132
±4595503909548
4.746605039095395392
NS517450390955188
Twin307951560984298119166
pregnancies307952560984776118166212253300337358400434
13855520909539
(5.3%)39125209095215972112170190
14475520909539
(2.9%)45325209095215973111171191
NS517452090955188
Primipara30795376098457395163184232274303344
11382453790953970
(57.9%)39125379095215997103141201221
23443753790953978
(65.7%)45335379095215997110149208227
NS517453790955188
Prior30785496098457395140170
abortion326454960984189135164195216262308
73834549909539
(36.8%)38915499095215998113153213232
64468549909539
(17.1%)4525549909521579096131185205
NS517454990955188
NS307856190954982
–3175561909540
not322956190954182105
significant33495619095274383125141161179212252293316