Heart Vessels. 2025 Nov 17. doi: 10.1007/s00380-025-02630-7. Online ahead of print.
ABSTRACT
Our purpose was to determine the outcome of pregnancy and delivery in patients with coronary artery lesions and myocardial involvement caused by Kawasaki disease after half a century after the first report of this disease. We investigated 67 deliveries in 39 patients with coronary artery lesions caused by Kawasaki disease in our institution between 1991 and 2022. The age at delivery ranged from 18 to 42 years, with a median of 31 years. Twenty-four patients (62%) had stenotic lesions, including 11 with coronary arterial bypass grafting. Low-dose aspirin was given to 26 patients (67%). The deliveries were vaginal in 29 patients (74%), albeit that 16 required assistance by forceps or vacuum extraction under epidural anesthesia. Caesarean sections were performed in 10 patients (26%), 5 (13%) for cardiac disease. There were two patients with worsening ventricular tachycardia and two patients with ST-T depression on Holter monitoring during pregnancy. Three patients experienced an increase in isolated ventricular premature contractions during pregnancy. No severe maternal cardiac events occurred in any patients. There were four preterm babies less than 35 weeks of gestation (6%). The results of the pregnancy and delivery in patients without myocardial ischemia and involvement were favorable, even if they had stenotic lesions. Ventricular tachycardia can worsen during pregnancy in patients with myocardial involvement, and myocardial ischemia may also occur in patients with coronary artery occlusions. Their evaluation during pregnancy by Holter-electrocardiograms is helpful in deciding the management of the pregnancy and mode of delivery.
PMID:41249708 | DOI:10.1007/s00380-025-02630-7
