Multiple pregnancy in a primigravida with uncorrected Pentalogy of Fallot

Abstract

Pentalogy of Fallot is a cyanotic congenital heart disease that has guarded prognosis without surgical intervention in infancy. Women with uncorrected defects rarely survive into childbearing age and pregnancy in this group is associated with a high rate of perinatal loss. Physiological cardiovascular changes in pregnancy can lead to maternal haemodynamic instability with subsequent adverse cardiac sequelae with or without fetal decompensation. Optimum management and pregnancy outcomes in mother with uncorrected Pentalogy of Fallot and twin pregnancy have not been described in the literature. We describe a successful case of monochorionic diamniotic twin pregnancy in an affected woman who has not undergone surgical repair. Her pregnancy progressed without any adverse cardiopulmonary complications. Her caesarean delivery and postpartum recovery were favourable, with successful birth of two healthy babies at 35.7 weeks. This case emphasises the importance of a multidisciplinary team, especially of obstetricians with expertise in high-risk pregnancies, adult congenital heart disease cardiologists and anaesthesiologist.

Uncorrected pentalogy of Fallot with successful pregnancy—A case report

“…This is, to our knowledge, one of the few cases reported of a successful pregnancy in women with PoF without surgical repair [ 5 , 6 ]. It shows that it is possible, but it is not risk-free.…”

Pregnancy outcomes among 31 patients with tetralogy of Fallot, a retrospective study

“…Since pregnancy introduces extra load on the heart, and can damage cardiac functions, resulting in the increase in both maternal and perinatal morbidity [4,5]. Previous studies have demonstrated that cardiac and obstetric complications are more likely to occur in patients without surgical repair [6][7][8]. The most common cardiac complications include progressive dilatation of the right ventricle and ventricular failure, thromboembolism, atrial and ventricular arrhythmias, progressive aortic root dilatation and endocarditis [1,9].…”

Pregnancy outcomes among 31 patients with tetralogy of Fallot

“…Without repair, TOF patients rarely reach childbearing age and get pregnant. Since pregnancy introduces extra load on the heart, and can damage cardiac functions, resulting in the increase in both maternal and perinatal morbidity [4,5].Previous studies have demonstrated that cardiac and obstetric complications are more likely to occur in patients without surgical repair [6][7][8]. The most common cardiac complications include progressive dilatation of the right ventricle and ventricular failure, thromboembolism, atrial and ventricular arrhythmias, progressive aortic root dilatation and endocarditis [1,9].…”