title: Pregnancy-related obstetric and cardiologic problems in women after atrial switch operation for transposition of the great arteries.
abstract: BACKGROUND
  The number of women with congenital heart disease reaching reproductive age has increased due to therapeutic advances. The aim of this study was to examine obstetric and cardiac problems during pregnancy after Mustard/Senning repair for transposition of the great arteries.
  
  
  RESULTS
  Sixty pregnancies in 34 women from 3 centers were studied. The women were interviewed, and their records reviewed for clinical status and diagnostic evaluation. Age range was 16-34 years during first pregnancy, and all were in a low functional class. There were 11 miscarriages and 5 abortions. Of 44 successful pregnancies, 20 were vaginal deliveries and 24, cesarean sections. A total of 25% were delivered prematurely. Thirteen babies had birth weight <2,500g. Deterioration in functional class occurred in 7 pregnancies, without recovery in 5. Deterioration in systolic function occurred in 4 of 44 echocardiographically documented pregnancies, without recovery in 75%. In 2 women resuscitation was necessary during delivery, in 1, supraventricular tachycardia occurred during labor.
  
  
  CONCLUSIONS
  Pregnancy is usually well-tolerated, but outcome is unforeseeable and life-threatening problems can occur. These women belong in cardiac care conducted by experienced congenital cardiologists, who systematically check for typical residua. The pregnancy should be planned and gynecologists/obstetricians with special expertise integrated into the consultations. During delivery a congenital cardiologist, and an anesthetist experienced in congenital cardiology, should be present for possible severe cardiac events.
authors: Department of Pediatric Cardiology and Congenital Heart Defects, German Heart Centre Munich.
authors: Vasiliki
authors: V
authors: Trigas
authors: Nicole
authors: N
authors: Nagdyman
authors: Stephanie
authors: S
authors: Pildner von Steinburg
authors: Erwin
authors: E
authors: Oechslin
authors: Manfred
authors: M
authors: Vogt
authors: Felix
authors: F
authors: Berger
authors: Karl-Theo Maria
authors: KT
authors: Schneider
authors: Peter
authors: P
authors: Ewert
authors: John
authors: J
authors: Hess
authors: Harald
authors: H
authors: Kaemmerer
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D004562:Electrocardiography; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D047928:Premature Birth / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D014188:Transposition of Great Vessels / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery