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.

Keywords:

• Cardiac complication
• congenital heart disease
• obstetric/neonatal outcome

Acknowledgements

The authors thank Robin Krauze and Prof. Tadeusz Krauze for their invaluable remarks and language help, and Prof. Michał Troszyński for permission to use his results.

Declaration of interest

The authors report no declarations of interest.