Autore et al identified risk factors for mortality in pregnant women with hypertrophic cardiomyopathy. These can help a woman to reach an informed decision about whether or not to undergo pregnancy. The authors are from multiple hospitals in Italy.
In general the risk of mortality in a woman with hypertrophic cardiomyopathy is increased compared to the general population. However, for most of these women the absolute risk is still low unless certain risk factors are present.
Factors associated with a high risk of mortality during or shortly after a pregnancy:
(1) serious clinical deterioration during a previous pregnancy
(2) massive left ventricular hypertrophy with significant left ventricular outflow obstruction
(3) malignant family history of early death
(4) major progression of symptoms during the pregnancy to NYHA Class III or IV
(5) presence of significant arrhythmias and/or syncope prior to becoming pregnant
An additional issue for the woman involves genetic counseling. Hypertrophic cardiomyopathy is an autosomal dominant disorder, so all children will be affected.
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