Singh T, Mishra AK, Vojjala N, John KJ, George AA, Jha A, Hadley M. Cardiovascular complications following medical termination of pregnancy: An updated review. World J Cardiol 2023; 15(10): 518-530 [PMID: 37900907 DOI: 10.4330/wjc.v15.i10.518]
Corresponding Author of This Article
Ajay K Mishra, FACP, MBBS, MD, Academic Fellow, Division of Cardiology, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, United States. ajay.mishra@stvincenthospital.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Oct 26, 2023; 15(10): 518-530 Published online Oct 26, 2023. doi: 10.4330/wjc.v15.i10.518
Cardiovascular complications following medical termination of pregnancy: An updated review
Tejveer Singh, Ajay K Mishra, Nikhil Vojjala, Kevin John John, Anu A George, Anil Jha, Michelle Hadley
Tejveer Singh, Anu A George, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Ajay K Mishra, Anil Jha, Michelle Hadley, Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
Nikhil Vojjala, Department of Internal Medicine, Post-Graduation Institute of Medical Education and Research, Chandigarh 00000, India
Kevin John John, Department of Internal Medicine, Tufts Medical Center, Boston, MA 01212, United States
Author contributions: Mishra AK and Hadley M planned and formulated the study; Singh T and Vojjala N collected and analysed the data; Singh T, Mishra AK, John KJ, George AA, and Jha A completed the manuscript; Singh T and Mishra AK revised the manuscript; Mishra AK and Hadley M reviewed the manuscript; and Hadley M approved the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ajay K Mishra, FACP, MBBS, MD, Academic Fellow, Division of Cardiology, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, United States. ajay.mishra@stvincenthospital.com
Received: June 15, 2023 Peer-review started: June 15, 2023 First decision: August 10, 2023 Revised: August 22, 2023 Accepted: September 18, 2023 Article in press: September 18, 2023 Published online: October 26, 2023 Processing time: 126 Days and 4.7 Hours
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.
