402. Role of non-specialized tertiary perinatal center for the care of pregnancy complicated with adult congenital heart disease

Prognosis of congenital heart disease has been improved remarkably and many women with the disease have become able to reach to the reproductive age. The pregnant women of adult congenital heart disease (ACHD) has been therefore increasing and most of them have uneventful pregnancy. However, cardiac function and condition are diverse even in the same disease and the care for them are therefore different from case by case. Specialized care for them should be important but the number of specialized institute has not reached to sufficient to take care of the women. Experience of the care of many cases should be accumulated and shared in order to provide high-quality management. The medical records of pregnancy in the ACHD women that managed at our hospital from 2010 to 2017 were reviewed. The situation of the management, the evaluation, the medication, and the strategy during and after pregnancy were investigated. Forty-four cases and fifty-three pregnancies were identified. VSD was the most major disease. All of them were in NYHA 1 at the first visit and none of them had cardiac events during and after pregnancy. A severe AS case was referred to the specialized institute for the care and the therapeutic approach based on more experience of ACHD. It is possible that a pregnant woman with ACHD in NYHA 1 with no remarkable symptom may get worse in heart condition as the pregnancy progress. As ACHD has diverse condition even in the same disease, individual evaluation is very important and the most appropriate management should be provided. Most of them are mild and may be taken care at a non-specialized hospital.