Pregnancy in women with complete transposition of the great arteries following the atrial switch procedure. A study from three of the largest Adult Congenital Heart Disease centers in Poland

Abstract

Objective: We sought to identify maternal/neonatal and cardiovascular complications in pregnant women with complete transposition of great arteries (D-TGA) following atrial switch.Methods: Clinical records of all women with D-TGA after the Mustard/Senning (M/S) operation who were followed at the three largest Adult Congenital Heart Disease (ACHD) centers in Poland were reviewed.Results: Fifteen of the fifty-nine women followed had a total of 24 pregnancies, including two spontaneous miscarriages. Twenty-two pregnancies (92%) resulted in a live birth, 91% were by cesarean section. During 5 (23%) of the 22 completed pregnancies obstetric complications were observed (one gestational diabetes, one hypertension in pregnancy, one placenta increta and two preterm labors). The mean pregnancy duration was 37.2 weeks (range: 26–41 weeks).We observed one neonatal death due to extreme prematurity. Six (25%) children had a birth weight of ≤2500 g. None of women had severe cardiac complications during pregnancy nor in the postpartum period.Conclusions: In our study, we demonstrated a large number of obstetric complications and low birth weight in the presence of a systemic right ventricle. However, from a cardiologist’s point of view pregnancy after the M/S operation was well-tolerated and relatively safe.