Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries

Drenthen, Willem; Pieper, Petronella G.; Ploeg, Matthias; Voors, Adriaan A.; Roos‐Hesselink, Jolien W.; Mulder, Barbara J.M.; Vliegen, Hubert W.; Sollie, Krystyna M.; Ebels, Tjark; Veldhuisen, Dirk J. van

doi:10.1093/eurheartj/ehi472

Cited by 119 publications

(102 citation statements)

References 24 publications

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“…This is lower than in other studies, in which 25-35% deterioration was reported. 3, 14 The lower rate is possibly due to careful and accurate follow-up care in experienced centers, and that patients with unfavorable prognosis were advised against pregnancy early on. Even so, only 33% returned to their prepregnancy state, whereas in other studies up to 70% recovery women after ASO, describing the course of 60 pregnancies in 34 women.…”

Section: Trigas V Et Almentioning

confidence: 99%

Pregnancy-Related Obstetric and Cardiologic Problems in Women After Atrial Switch Operation for Transposition of the Great Arteries

Trigas

Nagdyman

Steinburg

et al. 2014

Circ J

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Section: Trigas V Et Almentioning

confidence: 99%

Pregnancy-Related Obstetric and Cardiologic Problems in Women After Atrial Switch Operation for Transposition of the Great Arteries

Trigas

Nagdyman

Steinburg

et al. 2014

Circ J

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“…Documented cardiac, obstetric and neonatal events were classified according to predefined criteria. 12 …”

Section: Study Protocolmentioning

confidence: 99%

Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

Yap

Drenthen

Pieper

et al. 2010

BJOG

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Objective To compare the risks of pregnancy complications in women with repaired and unrepaired isolated ventricular septal defect (VSD).Design A retrospective multicentre study.Setting Tertiary centres in the Netherlands and Belgium.Methods Women were identified using two congenital heart disease registries. Eighty-eight women were identified who had experienced 202 pregnancies, including 46 miscarriages and nine terminations of pregnancy. Information on each completed pregnancy (n = 147; unrepaired VSD, n = 104; repaired VSD, n = 43) was obtained using medical records and telephone interviews. Data from the Generation R database (prospective cohort study; n = 9667) were used to determine the background risk (controls). Odds ratios and 95% CI were estimated using general estimation equation analysis adjusted for multiple pregnancies per woman, maternal age and parity status.Main outcome measures Adjusted odds ratios (AORs) for developing pregnancy complications in relation to corrective status.Results Pregnancies in women with an unrepaired VSD were associated with a higher risk of pre-eclampsia (AOR 4.59, 95% CI 2.01-10.5, P < 0.001) compared with controls. No differences were observed when comparing women with repaired VSD and controls. Pregnancies in women with repaired VSD were associated with a higher risk of premature labour (AOR 4.02, 95% CI 1.12-14.4, P = 0.03) and small-for-gestational-age (SGA) births (AOR 4.09, 95% CI 1.27-13.2, P = 0.02) compared with women with unrepaired VSD.Conclusions Women with unrepaired VSD are at increased risk of pre-eclampsia, which suggests that it is not a benign condition. In addition, women with repaired VSD are at increased risk of premature labour and SGA births compared with women with unrepaired VSD.

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“…Our only atrial switch patient had good systemic RV function, no significant TR and no previous arrhythmias, putting her in a more advantageous position for a good maternal outcome. [6,[21][22][23] Both women with Fontan palliation had good NYHA status, retained ventricular function and no significant atrioventricular valve regurgitation at baseline, all factors considered favourable with this type of circulation. [6] However, a previous history of atrial arrhythmias requiring treatment and a possibly less efficient type of Fontan circuit (classical Fontan with right atrium to pulmonary artery conduit) in the patient with AP Fontan resulted in a difference in occurrence of cardiac events between the pregnancies.…”

Section: Discussionmentioning

confidence: 90%

The Impact of Maternal Congenital Heart Disease on Pregnancy Outcomes in Malta – a Retrospective Study

Caruana

Gatt

Aquilina

et al. 2017

ICFJ

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Background: Most female patients with congenital heart disease (CHD) are becoming pregnant. Maternal CHD can have a negative impact on mother and foetus. This is the first study investigating pregnancy outcomes in Maltese grown-up congenital heart disease (GUCH) patients and one of few to compare these with outcomes in women without heart disease.Methods: Known GUCH pregnancies for the period of 2007-2014 were extracted from our database (GUCH cohort) and cardiovascular outcomes retrieved from hospital notes. A control cohort of 540 pregnancies in women without cardiovascular disease was generated through twenty-fold random matching based on subject age from among all pregnancies in Maltese nationals for the same 8-year period. Obstetric and offspring outcomes were compared between the two cohorts.Results: The GUCH cohort consisted of 27 pregnancies in 24 women. Only 1/27 patients (3.7%) had cardiovascular complications. Elective Caesarean sections were commoner (29.6% vs. 15.4%) and unassisted vaginal deliveries less frequent (51.9% vs. 64.6%) in the GUCH cohort (p=0.02). Obstetric complication rates were similar. GUCH women had smaller babies (median 3030g vs. 3230g; p=0.045) and showed a trend towards more small-for-gestational age babies (18.5% vs. 8.4%; p=0.08) and congenital malformations (7.4% vs. 2.4%; p=0.06).Conclusions: Despite the potential adverse effects of maternal CHD on mother and foetus, most pregnancies are uncomplicated and outcomes comparable to those in women without heart disease, particularly if baseline clinical status is good. Based on our findings, it is being proposed that prospective mothers be counselled about the possibility of having smaller infants.

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Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries

Abstract: In this largest report on pregnancy in women with atrial-corrected TGA to date, a high incidence of obstetric complications and mortality in the offspring was observed.

Cited by 119 publications

References 24 publications

Pregnancy-Related Obstetric and Cardiologic Problems in Women After Atrial Switch Operation for Transposition of the Great Arteries

Pregnancy-Related Obstetric and Cardiologic Problems in Women After Atrial Switch Operation for Transposition of the Great Arteries

Pregnancy outcome in women with repaired versus unrepaired isolated ventricular septal defect

The Impact of Maternal Congenital Heart Disease on Pregnancy Outcomes in Malta – a Retrospective Study

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