Aims Hypertensive disorders of pregnancy (HDP) occur in 10% of pregnancies in the general population, pre-eclampsia specifically in 3–5%. Hypertensive disorders of pregnancy may have a high prevalence in, and be poorly tolerated by, women with heart disease. Methods and results The prevalence and outcomes of HDP (chronic hypertension, gestational hypertension or pre-eclampsia) were assessed in the ESC EORP ROPAC (n = 5739), a worldwide prospective registry of pregnancies in women with heart disease. The overall prevalence of HDP was 10.3%, made up of chronic hypertension (5.9%), gestational hypertension (1.3%), and pre-eclampsia (3%), with significant differences between the types of underlying heart disease (P < 0.05). Pre-eclampsia rates were highest in women with pulmonary arterial hypertension (PAH) (11.1%), cardiomyopathy (CMP) (7.1%), and ischaemic heart disease (IHD) (6.3%). Maternal mortality was 1.4 and 0.6% in women with vs. without HDP (P = 0.04), and even 3.5% in those with pre-eclampsia. All pre-eclampsia-related deaths were post-partum and 50% were due to heart failure. Heart failure occurred in 18.5 vs. 10.6% of women with vs. without HDP (P < 0.001) and in 29.1% of those with pre-eclampsia. Perinatal mortality was 3.1 vs. 1.7% in women with vs. without HDP (P = 0.019) and 4.7% in those with pre-eclampsia. Conclusion Hypertensive disorders of pregnancy and pre-eclampsia rates were higher in women with CMP, IHD, and PAH than in the general population. Adverse outcomes were increased in women with HDP, and maternal mortality was strikingly high in women with pre-eclampsia. The combination of HDP and heart disease should prompt close surveillance in a multidisciplinary context and the diagnosis of pre-eclampsia requires hospital admission and continued monitoring during the post-partum period.

中文翻译：

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患有心脏病的孕妇的高血压疾病：ESC EORP ROPAC 登记处

目的 妊娠期高血压疾病 (HDP) 发生在一般人群中 10% 的妊娠中，先兆子痫尤其占 3-5%。妊娠期高血压疾病在患有心脏病的女性中患病率高，并且耐受性差。方法和结果 在 ESC EORP ROPAC (n = 5739) 中评估了 HDP（慢性高血压、妊娠高血压或先兆子痫）的患病率和结果，这是一个全球范围内对患有心脏病的女性进行的前瞻性妊娠登记。HDP总患病率为10.3%，由慢性高血压（5.9%）、妊娠高血压（1.3%）和先兆子痫（3%）组成，基础心脏病类型之间存在显着差异（P < 0.05） ). 患有肺动脉高压 (PAH) (11.1%)、心肌病 (CMP) (7.1%)、和缺血性心脏病 (IHD) (6.3%)。孕产妇死亡率在有 HDP 和没有 HDP 的妇女中分别为 1.4% 和 0.6% (P = 0.04)，在有先兆子痫的妇女中甚至为 3.5%。所有与先兆子痫相关的死亡都是产后死亡，50% 是由于心力衰竭。心力衰竭发生在 18.5% 和 10.6% 的有 HDP 和没有 HDP 的女性中 (P < 0.001)，在有先兆子痫的女性中有 29.1% 发生心力衰竭。围产期死亡率在有和没有 HDP 的妇女中分别为 3.1% 和 1.7% (P = 0.019)，在有先兆子痫的妇女中为 4.7%。结论 患有 CMP、IHD 和 PAH 的女性妊娠期高血压疾病和先兆子痫的发生率高于一般人群。患有 HDP 的女性的不良后果增加，而患有先兆子痫的女性的孕产妇死亡率高得惊人。