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Pregnancy with Tetralogy of Fallot

Konstantina Velikova, Denica Koleva, Galina Dimova, Ivelina Hristova, Rumen Iordanov

Abstract

Introduction: Tetralogy of Fallot is a congenital heart defect that is present at birth. It features four problems: a ventricular septal defect, pulmonary stenosis, a right ventricular hypertrophy  and an overriding aorta. The cause of the tetralogy of Fallot is not known and it is most often diagnosed in the first few weeks of life due to either a loud heart murmur or cyanosis. Children having a tetralogy spell will initially become extremely irritable in response to the critically low oxygen levels and may become sleepy or unresponsive if the severe cyanosis persists.

The aim of our research was to evaluate the pregnancy outcome in women with tetralogy of Fallot. The study was a retrospective analysis of maternal and perinatal outcome in 3 women with TOF treated in a cardio-obstetric unit. One of the women with this uncorrected congenital heart defect had one child. Obstetric and cardiac complications were more frequent in the uncorrected tetralogy.

Materials and Methods: A retrospective analysis of maternal and perinatal outcome of pregnancies in women with TOF who were seen in the obstetrics unit in Varna’s hospital - Maichin Dom. All women were supervised in the cardio-obstetric clinic under joint supervision of obstetrician and cardiologists. These women were kept under observation post partum.

Results: The outcome of our research was that in the women with a corrected condition - there were 100% live births to term. In the uncorrected woman there was one preterm birth. There was 1 neonatal death in the uncorrected woman, too. No baby was determined to have a congenital anomaly, including congenital cardiac malformations.

Conclusion: Tetralogy of Fallot carries substantial risk to mother and fetus. Surgical correction is associated with improved maternal and perinatal outcome. These patients need detailed pre-pregnancy evaluation and should be under joint supervision of an obstetrician, a cardiologist, a congenital cardiac surgeon, and an anesthetist.


Keywords

risk, pregnancy, tetralogy of Fallot, complications


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