European Heart Journal Advance Access originally published online on August 25, 2005
European Heart Journal 2005 26(23):2588-2595; doi:10.1093/eurheartj/ehi472
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Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries
1Department of Cardiology, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands
2Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
3Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands
4Department of Cardiology, University Medical Center Leiden, Leiden, The Netherlands
5Department of Obstetrics and Gynecology, University Medical Center Groningen, Groningen, The Netherlands
6Department of Thoracic Surgery, University Medical Center Groningen, Groningen, The Netherlands
Received 16 April 2005; revised 21 July 2005; accepted 4 August 2005; online publish-ahead-of-print 25 August 2005.
* Corresponding author. Tel: +31 50 361 0248; fax: +31 50 361 4391. E-mail address: w.drenthen{at}thorax.umcg.nl
Aims To investigate magnitude and determinants of risks during pregnancy in women with Mustard or Senning repair for complete transposition of the great arteries (TGA).
Methods and results Using a nationwide registry (CONCOR), 70 women with Senning (23%) or Mustard (77%) repair for TGA were enrolled. A total of 28 patients had 69 pregnancies (two twins), including 17 spontaneous miscarriages and three elective abortions. During 39 of the 49 completed pregnancies, complications were observed. The most important cardiac complication was clinically significant arrhythmia (n=11, 22%), especially occurring in patients with a prior history of arrhythmia. Important general pregnancy complications were preeclampsia (n=5, 10.2%) and pregnancy-induced hypertension (n=4, 8.2%). Obstetric complications included premature rupture of membranes (n=7, 14.3%), premature labour (n=12, 24.4%), premature delivery (n=16, 31.4%), and thrombo-embolic complications (n=2, 4.1%). Mean (singleton) pregnancy duration was 36±5 weeks. Eleven of the 51 children (21.6%) were small for gestational age. Foetal and neonatal mortality combined was 11.8% (n=6). No recurrence of congenital heart disease in the offspring was documented.
Conclusion In this largest report on pregnancy in women with atrial-corrected TGA to date, a high incidence of obstetric complications and mortality in the offspring was observed.
Key Words: Congenital heart disease • Pregnancy • Transposition of great arteries
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