Outcome of pregnancies in patients with complex pulmonary atresia.

Abstract

Objective-To evaluate the outcome of pregnancies in patients with complex pulmonary atresia, comparing those with and without previous radical surgical repair.

Successful Management of Pregnancy in Uncorrected Tetralogy of Fallot with Pulmonary Atresia

“…Maternal mortality with pulmonary atresia is reported to be low with only two maternal deaths reported [5,6]. There is lack of evidence regarding the optimal time and mode of delivery in these patients.…”

“…Two case series, comprising 14 patients of TOF with pulmonary atresia with no corrective surgery, report a total of 35 pregnancies with successful pregnancy outcomes in 10 cases with live birth rates of 51 and 44 %, respectively [4,5]. Presbitero concluded that the probability of live birth could be predicted by hemoglobin of [20gm % and saturation \85 %.…”

Case report of a parturient with cyanotic congenital heart disease palliated with a Glenn procedure

“…Maternal Hb level and SpO 2 showed a significant relationship to fetal outcomes, with a higher maternal Hb and lower SpO 2 correlating with more pregnancy losses. In a large series of pregnancies in patients with maternal complex pulmonary atresia (a related cardiovascular physiologic process), Neumayer and Somerville provided details of 41 pregnancies in 15 patients [7]. Of the total 41 pregnancies, there were 23 live births; two of these neonates subsequently died.…”

Management of pregnancy in women with congenital heart disease

“…This is often the case in the following situations: operated tetralogy of Fallot, right ventricle to pulmonary conduits used to repair truncus arteriosus or pulmonary atresia with ventricular septal defect (VSD), or repaired malposition of the great arteries with VSD. This situation is often well tolerated, even in cases of severe pulmonary regurgitation, and delivery might be normal 8. The fear of ventricular or atrial arrhythmia can sometimes lead to pre-pregnancy pulmonary valve replacement, if the functional status before pregnancy is greatly impaired.…”