Pregnancy and long-term cardiovascular outcomes in women with congenitally corrected transposition of the great arteries

Abstract

ObjectiveTo define maternal/neonatal outcomes and long-term cardiovascular effects of pregnancy in women with congenitally corrected transposition of the great arteries (ccTGA). MethodsClinical records of all women with ccTGA who were followed at a tertiary care center in Poland between April 1991 and April 2012 were retrospectively reviewed. ResultsOf the 20 pregnancies among 13 women identified, 19 (95%) were successful. Of the 19 deliveries, 14 (74%) were vaginal and 5 (26%) were cesarean. Cardiovascular complications during pregnancy and childbirth occurred in 3 patients (16% of successful pregnancies). Two women developed supraventricular arrhythmias; they were observed and required no pharmacologic treatment. One patient required premature delivery for documented deterioration of right ventricular function. There were no pregnancy-related maternal deaths. In 1 case, congenital heart disease was diagnosed in the offspring. With regard to long-term follow-up, no differences were found in terms of heart failure admissions, pharmacologic treatment, deaths, or echocardiographic parameters compared with non-pregnant women with ccTGA. ConclusionSuccessful pregnancy can be achieved by most women with ccTGA. The most common cardiovascular complications are supraventricular arrhythmias but pregnancy does not seem to impair right ventricular function in the long term. Nevertheless, preconception counseling and tertiary care during pregnancy for women with ccTGA are recommended.