Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries.
OBJECTIVE
To investigate magnitude and determinants of risks during pregnancy in women with Mustard or Senning repair for complete transposition of the great arteries (TGA).


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.


CONCLUSIONS
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.
Drenthen
Willem
W
Department of Cardiology, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Pieper
Petronella G
PG
Ploeg
Martine
M
Voors
Adriaan A
AA
Roos-Hesselink
Jolien W
JW
Mulder
Barbara J M
BJ
Vliegen
Hubert W
HW
Sollie
Krystyna M
KM
Ebels
Tjark
T
van Veldhuisen
Dirk J
DJ
D000022:Abortion, Spontaneous / Q000209:etiology; D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D014188:Transposition of Great Vessels / Q000601:surgery*