Pregnancy outcomes in women with congenitally corrected transposition of the great arteries

Abstract

The aim of this study was to define the pregnancy outcomes in women with congenitally corrected transposition of the great arteries (cc-TGA). The medical databases at Anzhen Hospital between January 2011 and March 2018 were retrospectively reviewed. Data of 12 pregnant women with cc-TGA were collected. One patient was lost at 35 weeks of gestation. There were 8 (72.7%) term births and 3 (27.3%) premature births. Of the 11 deliveries, 2 (18.2%) were vaginal and 9 (81.8%) were cesarean. The baseline New York Heart Association (NYHA) functional class was I - II in 11 patients, II - III in 7 patients, and III - IV in 5 patients in the third trimester (P = 0.037). In the third trimester, 6 (50%) patients became symptomatic and experienced heart function deterioration compared with asymptomatic patients (6 vs. 0, P = 0.002). In the third trimester, tricuspid regurgitation (TR) was identified in 11 patients: 2 with mild TR, 4 with moderate TR, and 5 with severe TR. Five symptomatic patients developed severe TR, in which the rate of TR was significantly higher than that of asymptomatic patients (5 vs. 0, P = 0.015). No difference was found in NYHA class between the third trimester and 1 week after delivery (P > 0.05). One patient died of ventricular fibrillation at 3 months postpartum. Successful pregnancy can be achieved by most women with cc-TGA. The deterioration of right ventricular function is common among pregnant women with cc-TGA, and severe TR is a high risk factor resulting in deterioration of the right ventricular function.

Keywords

• pregnancy
• congenitally corrected transposition of the great artery
• systemic right ventricle