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. 2023 Oct 26;15(10):518-530.
doi: 10.4330/wjc.v15.i10.518.

Cardiovascular complications following medical termination of pregnancy: An updated review

Tejveer Singh  1 , Ajay K Mishra  2 , Nikhil Vojjala  3 , Kevin John John  4 , Anu A George  1 , Anil Jha  5 , Michelle Hadley  5
Affiliations

Cardiovascular complications following medical termination of pregnancy: An updated review

Tejveer Singh et al. World J Cardiol. .

Abstract

Background: Around 1 million cases of medical termination of pregnancy (MTP) take place yearly in the United States of America with around 2 percent of this population developing complications. The cardiovascular (CVD) complications occurring post MTP or after stillbirth is not very well described.

Aim: To help the reader better understand, prepare, and manage these complications by reviewing various cardiac comorbidities seen after MTP.

Methods: We performed a literature search in PubMed, Medline, RCA, and google scholar, using the search terms "abortions" or "medical/legal termination of pregnancy" and "cardiac complications" or "cardiovascular complications".

Results: The most common complications described in the literature following MTP were infective endocarditis (IE) (n = 16), takotsubo cardiomyopathy (TTC) (n = 7), arrhythmias (n = 5), and sudden coronary artery dissection (SCAD) (n = 4). The most common valve involved in IE was the tricuspid valve in 69% (n = 10). The most observed causative organism was group B Streptococcus in 81% (n = 12). The most common type of TTC was apical type in 57% (n = 4). Out of five patients developing arrhythmia, bradycardia was the most common and was seen in 60% (3/5) of the patients. All four cases of SCAD-P type presented as acute coronary syndrome 10-14 d post termination of pregnancy with predominant involvement of the right coronary artery. Mortality was only reported following IE in 6.25%. Clinical recovery was reported consistently after optimal medical management following all these complications.

Conclusion: In conclusion, the occurrence of CVD complications following pregnancy termination is infrequently documented in the existing literature. In this review, the most common CVD complication following MTP was noted to be IE and TTC.

Keywords: Cardiovascular complications; Infective Endocarditis; Outcome; Stress cardiomyopathy; Termination of pregnancy.

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Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Figures

Figure 1
Figure 1
Flow diagram of study participant inclusion. SCAD: Sudden coronary artery dissection.
Figure 2
Figure 2
Cardiovascular complications following medical terminations of pregnancy. SCAD: Sudden coronary artery dissection; EKG: Electrocardiographic.
See this image and copyright information in PMC

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