Pregnancy in women with a systemic right ventricle after surgically and congenitally corrected transposition of the great arteries

Abstract

ObjectiveTo determine maternal and neonatal outcomes in women with a systemic right ventricle (RV). Study designA retrospective (historical) cohort study of maternal and neonatal outcomes at a tertiary referral academic obstetric unit (Chelsea and Westminster Hospital, London). ResultsNineteen pregnancies in 14 women with a systemic RV were compared with 76 controls. There were no maternal deaths. In the study group cardiac complications occurred in six (32%) pregnancies. Obstetric complications occurred in four (21%) case pregnancies, not significantly higher than in the control group. The rate of neonatal complication was significantly higher in the study population with neonatal complications in 12 (63%) case pregnancies compared with 13 (17%) control pregnancies. The median birthweight centile was 9 in the study population, significantly lower than the control population. ConclusionsOur cohort study demonstrates high maternal and neonatal morbidity and low birthweight in the presence of a systemic RV. Cardiac complications were more common in women with RV dysfunction and arrhythmias prior to pregnancy. Preconception counselling and tertiary care during pregnancy for these patients is highly advisable.