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Outcomes of pregnancy in women with tetralogy of Fallot*

Published online by Cambridge University Press:  01 August 2008

Lia M. Pedersen ,
Thais A. L. Pedersen ,
Hanne B. Ravn  and
Vibeke E. Hjortdal
Lia M. Pedersen*
Affiliation:
Department of Cardiothoracic Surgery, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark
Thais A. L. Pedersen
Affiliation:
Department of Cardiothoracic Surgery, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark
Hanne B. Ravn
Affiliation:
Department of Anaesthesia and Intensive Care, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark
Vibeke E. Hjortdal
Affiliation:
Department of Cardiothoracic Surgery, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark
*
Correspondence to: Dr Lia Mendes Pedersen, Department of Cardiothoracic Surgery, Skejby Hospital, Aarhus University Hospital, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark. Tel: +45 8949 5481; Fax: +45 8949 6016; E-mail: lia-kris@dadlnet.dk
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Abstract

Background

Surgical results after repair of tetralogy of Fallot have remained excellent for the last decades, with current long-term rates of survival over 95%. Since functional capacity, quality of life, and social interactions are basically normal in this large group of patients, pregnancy obviously becomes a relevant issue for the female subgroup. In consequence, adequate obstetrical and cardiological management of pregnancy is particularly important.

Objective

To describe the outcomes of pregnancy, and fertility, in a series of women who underwent surgery for tetralogy of Fallot in a single centre.

Methods and results

We obtained data from hospital records, national registries, and questionnaires on 78 women who underwent surgical correction of tetralogy of Fallot between 1972 and 1992. Of 58 women who reached an age of at least 18 years, with 45 of this cohort currently surviving, 13 having died as adults, there were 54 pregnancies in 25 women. The recorded rate of spontaneous abortion was 15%, and infertility rate was 3.4%. There have been 41 life births, with a median weight at birth of 3.2 kg. Only 1 newborn was small for gestational age, and no one was born before the 36th week. The recurrence rate of congenital heart disease was high, at 9.8%. Cardiac complications during or after pregnancy were not observed, and only one woman had pre-eclampsia.

Conclusions

Pregnancy is well tolerated in women with tetralogy of Fallot, and an excellent neonatal outcome is expected. The recurrence risk of congenital cardiac disease, most often tetralogy of Fallot, is high.

Keywords

Congenital heart diseasegrown-up congenital heartcyanosisarrhythmia
Type
Original Article
Information
Cardiology in the Young , Volume 18 , Issue 4 , August 2008 , pp. 423 - 429
Copyright
Copyright © Cambridge University Press 2008

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Footnotes

*

The study has received a grant from Skejby Hospital Research Foundation, valued at DKK 10,000.

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