Abstract
Objectives We sought to determine pregnancy outcomes in patients with tetralogy of Fallot (TOF). Background Pregnancy outcomes in patients with TOF are incompletely defined. Methods Clinical, hemodynamic, and obstetric data were reviewed for women with TOF and prior pregnancy. Results Of 72 respondents, 43 (mean age, 26 years) had 112 pregnancies (range, 1 to 5); 82 pregnancies were successful. Eight women had unrepaired TOF at the time of their 20 successful pregnancies. At first assessment (age ≥18 years), six patients had pulmonary hypertension, three had moderate or severe right ventricular (RV) systolic dysfunction, and 13 had severe RV dilation due to pulmonic regurgitation. Sixteen patients had 30 miscarriages (27%) and one term stillbirth. Mean overall birth weight was 3.2 kg (range, 2.1 to 4.2 kg). Unrepaired TOF (p = 0.05) and morphologic pulmonary artery abnormality (p = 0.03) were independently predictive of infant birth weight. Six patients had cardiovascular complications during pregnancy: supraventricular tachycardia in two, heart failure in two, pulmonary embolism in a patient with pulmonary hypertension, and progressive RV dilation in a patient with severe pulmonic regurgitation. Five infants (6%) had congenital anomalies. Conclusions Patients with TOF have an increased risk of fetal loss, and their offspring are more likely to have congenital anomalies than offspring in the general population. Adverse maternal events, although rare, may be associated with left ventricular dysfunction, severe pulmonary hypertension, and severe pulmonic regurgitation with RV dysfunction.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 174-180 |
| Number of pages | 7 |
| Journal | Journal of the American College of Cardiology |
| Volume | 44 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 7 2004 |
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Keywords
- left ventricle/ventricular
- LV
- PA
- PHT
- pulmonary artery
- pulmonary hypertension
- right ventricle/ventricular
- RV
- tetralogy of Fallot
- TOF
ASJC Scopus subject areas
- Nursing(all)
Cite this
Outcomes of pregnancy in women with tetralogy of fallot. / Veldtman, Gruschen R.; Connolly, Heidi M.; Grogan, Martha; Ammash, Naser M.; Warnes, Carole A.
In: Journal of the American College of Cardiology, Vol. 44, No. 1, 07.07.2004, p. 174-180.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Outcomes of pregnancy in women with tetralogy of fallot
AU - Veldtman, Gruschen R.
AU - Connolly, Heidi M.
AU - Grogan, Martha
AU - Ammash, Naser M.
AU - Warnes, Carole A.
PY - 2004/7/7
Y1 - 2004/7/7
N2 - Objectives We sought to determine pregnancy outcomes in patients with tetralogy of Fallot (TOF). Background Pregnancy outcomes in patients with TOF are incompletely defined. Methods Clinical, hemodynamic, and obstetric data were reviewed for women with TOF and prior pregnancy. Results Of 72 respondents, 43 (mean age, 26 years) had 112 pregnancies (range, 1 to 5); 82 pregnancies were successful. Eight women had unrepaired TOF at the time of their 20 successful pregnancies. At first assessment (age ≥18 years), six patients had pulmonary hypertension, three had moderate or severe right ventricular (RV) systolic dysfunction, and 13 had severe RV dilation due to pulmonic regurgitation. Sixteen patients had 30 miscarriages (27%) and one term stillbirth. Mean overall birth weight was 3.2 kg (range, 2.1 to 4.2 kg). Unrepaired TOF (p = 0.05) and morphologic pulmonary artery abnormality (p = 0.03) were independently predictive of infant birth weight. Six patients had cardiovascular complications during pregnancy: supraventricular tachycardia in two, heart failure in two, pulmonary embolism in a patient with pulmonary hypertension, and progressive RV dilation in a patient with severe pulmonic regurgitation. Five infants (6%) had congenital anomalies. Conclusions Patients with TOF have an increased risk of fetal loss, and their offspring are more likely to have congenital anomalies than offspring in the general population. Adverse maternal events, although rare, may be associated with left ventricular dysfunction, severe pulmonary hypertension, and severe pulmonic regurgitation with RV dysfunction.
AB - Objectives We sought to determine pregnancy outcomes in patients with tetralogy of Fallot (TOF). Background Pregnancy outcomes in patients with TOF are incompletely defined. Methods Clinical, hemodynamic, and obstetric data were reviewed for women with TOF and prior pregnancy. Results Of 72 respondents, 43 (mean age, 26 years) had 112 pregnancies (range, 1 to 5); 82 pregnancies were successful. Eight women had unrepaired TOF at the time of their 20 successful pregnancies. At first assessment (age ≥18 years), six patients had pulmonary hypertension, three had moderate or severe right ventricular (RV) systolic dysfunction, and 13 had severe RV dilation due to pulmonic regurgitation. Sixteen patients had 30 miscarriages (27%) and one term stillbirth. Mean overall birth weight was 3.2 kg (range, 2.1 to 4.2 kg). Unrepaired TOF (p = 0.05) and morphologic pulmonary artery abnormality (p = 0.03) were independently predictive of infant birth weight. Six patients had cardiovascular complications during pregnancy: supraventricular tachycardia in two, heart failure in two, pulmonary embolism in a patient with pulmonary hypertension, and progressive RV dilation in a patient with severe pulmonic regurgitation. Five infants (6%) had congenital anomalies. Conclusions Patients with TOF have an increased risk of fetal loss, and their offspring are more likely to have congenital anomalies than offspring in the general population. Adverse maternal events, although rare, may be associated with left ventricular dysfunction, severe pulmonary hypertension, and severe pulmonic regurgitation with RV dysfunction.
KW - left ventricle/ventricular
KW - LV
KW - PA
KW - PHT
KW - pulmonary artery
KW - pulmonary hypertension
KW - right ventricle/ventricular
KW - RV
KW - tetralogy of Fallot
KW - TOF
UR - http://www.scopus.com/inward/record.url?scp=3242766009&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=3242766009&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2003.11.067
DO - 10.1016/j.jacc.2003.11.067
M3 - Review article
C2 - 15234429
AN - SCOPUS:3242766009
VL - 44
SP - 174
EP - 180
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 1
ER -