Cardiovascular complications following medical termination of pregnancy: An updated review

ARTICLE HIGHLIGHTS

Research background

Millions of medical terminations of pregnancy (MTP) take place yearly in the United States of America with a smaller percentage of this population developing complications. There is a lack of structured reporting of the cardiovascular (CVD) complications in this subset of patients.

Research motivation

The CVD complications occurring post MTP or after stillbirth are not very well described. The literature on the various CVD comorbidity following MTP is scanty.

Research objectives

In this review we aimed to study the various cardiac comorbidities seen after MTP, which will help the reader better understand, prepare, and manage these complications.

Research methods

A literature search in multiple databases including PubMed, Medline, RCA and google scholar, using the search terms “abortions” or “medical/Legal termination of pregnancy” and “cardiac complications” or “cardiovascular complications” were conducted. All research studies, clinical studies, case series, and case reports with relevant clinical details were included.

Research results

The most common complications described in the literature following MTP were infective endocarditis (IE), takotsubo cardiomyopathy (TTC), arrhythmia, and sudden coronary artery dissection (SCAD). The most common valve involved in IE was the tricuspid valve. The most observed causative organism of endocarditis was group B Streptococcus. The most common type of TTC was apical. Bradycardia was the most common arrhythmia. All four cases of SCAD-P type presented as acute coronary syndrome with predominant involvement of the right coronary artery. Mortality was only reported following IE in 6.25%. Clinical recovery occurred after optimal medical management following all these complications.

Research conclusions

The most common CVD complications following the MTP are IE, TTC, bradycardia, and SCAD. Most of these complications are adequately treated with appropriate medical management.

Research perspectives

As per the authors’ knowledge, this is the first review detailing on the clinical profile, imaging details, complications, and outcomes of the various CVD complications following MTP.