Pregnancy in women with a systemic right ventricle after surgically and congenitally corrected transposition of the great arteries

Eur J Obstet Gynecol Reprod Biol. 2011 Apr;155(2):146-9. doi: 10.1016/j.ejogrb.2010.12.021. Epub 2011 Jan 26.

Abstract

Objective: To determine maternal and neonatal outcomes in women with a systemic right ventricle (RV).

Study design: A retrospective (historical) cohort study of maternal and neonatal outcomes at a tertiary referral academic obstetric unit (Chelsea and Westminster Hospital, London).

Results: Nineteen pregnancies in 14 women with a systemic RV were compared with 76 controls. There were no maternal deaths. In the study group cardiac complications occurred in six (32%) pregnancies. Obstetric complications occurred in four (21%) case pregnancies, not significantly higher than in the control group. The rate of neonatal complication was significantly higher in the study population with neonatal complications in 12 (63%) case pregnancies compared with 13 (17%) control pregnancies. The median birthweight centile was 9 in the study population, significantly lower than the control population.

Conclusions: Our cohort study demonstrates high maternal and neonatal morbidity and low birthweight in the presence of a systemic RV. Cardiac complications were more common in women with RV dysfunction and arrhythmias prior to pregnancy. Preconception counselling and tertiary care during pregnancy for these patients is highly advisable.

MeSH terms

  • Adult
  • Arrhythmias, Cardiac / epidemiology
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / physiopathology
  • Congenitally Corrected Transposition of the Great Arteries
  • Female
  • Heart Ventricles / physiopathology*
  • Heart Ventricles / surgery
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • London / epidemiology
  • Male
  • Obstetric Labor Complications / epidemiology
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / epidemiology*
  • Pregnancy Outcome
  • Pulmonary Edema / epidemiology
  • Retrospective Studies
  • Transposition of Great Vessels / complications
  • Transposition of Great Vessels / surgery*
  • Ventricular Dysfunction, Right / etiology*
  • Ventricular Dysfunction, Right / physiopathology
  • Young Adult

Supplementary concepts

  • Congenitally corrected transposition of the great arteries