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POTS & Pregnancy--Interesting "research"


Poohbear
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This study only involved two patients but I found this interesting.

For those who are pregnant, you may want to contact these Dr's/researchers.

Source: Pacing Clin Electrophysiol (Pacing and clinical electrophysiology : PACE.) 2005 Jun; 28(6): 591-3

Additional Info: United States

Standard No: ISSN: 0147-8389; NLM Unique Journal Identifier: 7803944

Language: English

Abstract: INTRODUCTION: Postural orthostatic tachycardia syndrome (POTS) is a rare disease characterized by syncope, sinus tachycardia, and orthostasis due to autonomic dysfunction. METHODS AND RESULTS: Two women aged 26 and 24 years with severe POTS became pregnant. Both women experienced hyperemesis gravidarum with subsequent marked improvement in their POTS symptoms until 6 months gestation, when their syncope and sinus tachycardia caused clinical decompensation. Both patients delivered healthy babies at 37 weeks by elective cesarean section. CONCLUSION: In long-term follow-up, both women reported improvement in their prepartum symptoms. We describe the first report, to our knowledge, of two successful pregnancy outcomes in severe POTS, including the first report of midodrine use in pregnant women.

Record Type: Index Medicus

Article Type: Journal Article

Citation: Status: In-Process Owner: NLM

Date of Entry: 20050615

Accession No: PMID: 15955196

Database: MEDLINE

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hey thanks for the article poohbear! very interesting.. I know that my boyfreind and I have gone around and around debating on wheather or not to risk having children..... Thanks for the info.. its encouraging!

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I don't like that these researchers imply that most POTS sufferers have bad pregnancy outcomes. Many probably don't even know they have POTS because they aren't properly diagnosed. Although this is a positive thing that these two women had good outcomes, I am sure many others have good outcomes too. But no one wants to write about them because maybe there isn't enough research $$ involved.

Amy

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Amy

I'm confused by your statements because the article states these woman had GOOD outcomes after delivery as well as a decrease in POTS symptoms in the first 6 months of pregnancy. It does state that in their 6th month of pregnancy their POTS became worse but they still delivered healthy and also is encouraging that one was able to safely take Midodrine.

I don't think they are saying most women have bad pregnancies.

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I think Amy is just questioning why this report of two healthy pregnancies is considered significant enough to warrant publishing--unless the researchers were under the impression that women with POTS would have trouble with pregnancy. I also find it odd that the outcome of only two pregnancies makes it into a medical journal. BUT, I am glad we are getting some attention.

Obviously more research is needed!

Katherine

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Poohbear -- yes, Katherine is right in my thinking. If the researchers are saying "the first report ... of two successful pregnancy outcomes" is significant, then they are implying that many outcomes aren't. I just don't think that's true. Don't get me wrong; I am glad pregnancy & POTS is being studied. But just because this is the first foray into the medical journals doesn't mean women with POTS haven't been having successful pregnancies for many years.

Amy

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joanie--this can be true--that symptoms of some chronic conditions can improve during and after a pregnancy. My ob/gyn mentioned the "rule of thirds" that seems to hold in obstetrics--it seems that approximately 1/3 of women with some chronic conditions seem to improve with pregnancy, 1/3 stay the same, 1/3 get worse. She also said that she has found no way to predict the outcome for a particular woman, even from one pregnancy to another.

Katherine

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Katherine & Amy,

I understand where you are coming from.

Keep in mind this article is in the Journal of Pacing & clinical electrophysiology. Being cardiologists (not OB's) their practice isn't geared toward researching dysautonomia's. I think this is probably data that resulted from another study they were doing and it does appear to be the first study published on this issue. In terms of research terminology...it is therefore, the first "reported cases".

I still don't think they are implying these are the only two positive pregnancies they have seen in women with these disorders...simply that these are the first two documented, research protocoled patients who had some success while on medication during pregnancy. I don't think they are intending to imply other cases aren't positive just that in terms of true research, these are the first two documented cases.

In terms of why some women get better, some get worse and some stay the same, I agree with Katherine and what she's been told. Each pregnancy is so different and factors are different. I think it also depends on why you have dysautonomia to begin with as to what type of outcome one may have.

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