Successful Pregnancy with Uncorrected Tetralogy of Fallot: An Interdisciplinary Team Approach

Abstract

BACKGROUND: With an overall incidence of congenital cardiac disease, tetralogy of fallot (ToF) is the most clinical of cyanotic heart disease. The anomalies seen in patients with ToF are due to an inappropriate anterior and cephalad displacement of the interventricular septum’s infundibular (outflow tract) component. Ventricular septal defect, right ventricular hypertrophy, overriding aorta, and pulmonary stenosis are the four defects that result from this condition. The physiology of healthy women will undergo several changes affecting body system, including the cardiovascular system. Pregnancy and delivery have a high risk for most ill women, including those with uncorrected ToF, due to extensive physiological adaption and alterations. For patients with ToF, it continues to be a significant contributor to maternal morbidity (62.5%), mortality (10%), and neonatal adverse outcomes. CASE PRESENTATION: A 18-year-old female in her first pregnancy at 28 weeks was referred to Saiful Anwar Hospital with uncorrected ToF since she was 2 years old. She suggested repairing ToF at National Cardiovascular Center Harapan Kita Jakarta but her parents still refused. She married at 18 years old and she was pregnant unplanned before. Then, she was referred to RSSA for further management. CONCLUSSION: Pregnancy has been related with higher risks of morbidity and mortality for women with congenital cardiac disease. ToF is the most prevalent cyanosis congenital heart disease. These are poorly tolerated and produce serious complications, including maternal and neonatal mortality. Prenatal counselling is crucial to identify risk factors for the patients and to reassure many patients who are at low risk.