Cardiovascular magnetic resonance can be undertaken in pregnancy and guide clinical decision-making in this patient population

Abstract

AIMS\nCardiovascular disease is the leading cause of maternal morbidity and mortality, frequently requiring cardiac imaging for diagnosis, and follow-up. This need does not change pregnancy; however, many centres do not offer cardiovascular magnetic resonance (CMR) to pregnant patients. This paper explores current practice of CMR in pregnancy in four large volume centres, its safety and its impact on patient management.\n\n\nMETHODS AND RESULTS\nBetween 2008 and 2017, we collected consecutive pregnant patients between four centres. Guidelines and local standard operating procedures were followed and outcomes recorded modelled on the EuroCMR registry. Eighty-three women had diagnostic CMR without immediate complications. The commonest indication was vascular or congenital disease (48%), followed by cardiomyopathy/myocarditis (43%). Nineteen percent received contrast, and CMR changed management in 35% and in 50% of patients who received contrast.\n\n\nCONCLUSION\nIn this largest cohort to date describing CMR in pregnancy, we found that results frequently change management, thus adding valuable guidance for patient care. We conclude that CMR should be offered to pregnant women when indicated, including the administration of contrast as per current guidelines.