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Federación Mexicana de Ginecología y Obstetricia, A.C.

2010, Number 06

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Ginecol Obstet Mex 2010; 78 (06)

Pregnancy and tetralogy of Fallot with and without surgical correction

Torres-Gómez LG, Íñigo-Riesgo CA, Espinoza-Ortegón MA, Barba-Bustos AM, Marín-Solís B, Gómez-Vargas JR

Language: Spanish
References: 20
Page: 309-315
PDF size: 356.19 Kb.


ABSTRACT

Background: Tetralogy of Fallot is the most common cyanotic congenital cardiac lesions. Although pregnancy in patients with corrected tetralogy of Fallot usually have a satisfactory outcome, there may have maternal cardiovascular complications.
Objective: To report our experience in monitoring and treatment of 16 pregnancies in 14 women with tetralogy of Fallot.
Patients and method: Prospective study performed in 16 pregnancies of 14 patients with tetralogy of Fallot, who attended the services of Cardiology and High Risk Pregnancy in the Hospital de Gineco-Obstetricia of the Centro Médico de Occidente (Mexico), from January 1997 to January 2010. Nine women had total surgical correction and five hadn’t. All patients obtained complete study protocol and tests of fetal wellbeing.
Results: Hemoglobin and hematocrit were significantly higher in the group without surgical correction; this group also had lower oxygen saturation and right ventricular enlargement. Of the 16 pregnancies, five were resolved vaginally, the other by cesarean section. The cyanotic mothers had premature termination of pregnancy, lower birth weight and Apgar slightly deteriorated. There were no maternal or neonatal deaths, neither cardiac malformation in newborns.
Conclusions: There are more risks for the binomial in patients with uncorrected tetralogy of Fallot and in those operated with significant residual lesions. A greater anatomical impact was significantly correlated with major hemoglobin and minor oxygen saturation, which are the most important risk factors for adverse fetal outcomes.


REFERENCES

  1. Marelli AJ, Mackie AS, Lonescu-Ittu R, et al. Congenital heart disease in the general population. Changing prevalence and age distribution. Circulation 2007;115:163-172.

  2. Alva EC. Ante el adulto con cardiopatía congénita. Rev Mex Cardiol 2006;17(3):155-158.

  3. Pedersen LM, Pedersen TA, Ravn HB, Hjortdal VE. Outcomes of pregnancy in women with tetralogy of Fallot. Cardiol Young 2008;18:423-429.

  4. Child JS. Fallot’s tetralogy and pregnancy: prognostication and prophecy. J Am Coll Cardiol 2004;44:181-183.

  5. Attie F. Cardiopatías congénitas en el adulto. 2a ed. Madrid: Elsevier, 2003;p:247-252.

  6. López MGE, Quiroz A, Casanova JM, y col. Tetralogía de Fallot en adultos. Arch Inst Cardiol Mex 1997;67:405-410.

  7. Gelson E, Gatzoulis M, Steer PJ, et al. Tetralogy of Fallot: maternal and neonatal outcomes. BJOG 2008;115:398-402.

  8. Veldtman GR, Connolly HM, Grogan M, et al. Outcomes of pregnancy in women with tetralogy of Fallot. J Am Coll Cardiol 2004;44:174-80.

  9. Meijer JM, Pieper OG, Drenthen W, et al. Pregnancy, fertility, and recurrence risk in corrected tetralogy of Fallot. Heart 2005;91:801-805.

  10. Mendelson MA. Cardiopatías congénitas y embarazo. Atención perinatal de trastornos maternos crónicos. Clin Perinatología. México: McGraw-Hill Interamericana, 1997;2:485-500.

  11. Larsen-Disney P, Price D, Meredith I. Undiagnosed maternal Fallot tetralogy presenting in pregnancy. Aust NZ J Obstet Gynaecol 1992;32(2):169-171.

  12. Feigenbaum H. Ecocardiografía. 5a ed. Argentina: Médica Panamericana, 1994;p:398-399.

  13. Reynolds Terry. The Echocardiographer’s Pocket Reference. School of Cardiac Ultrasound. Arizona Heart Institute Foundation. Phoenix, Arizona, 1993.

  14. Carral y de Teresa, R. Semiología Cardiovascular. 5a ed. México: Nueva Editorial Interamericana, 1963, cap. 2, p:347-356.

  15. Friedman HH. Diagnóstico electrocardiográfico y vectocardiográfico. 3ª ed. Barcelona: Salvat, 1989, cap. 10, p:129-162.

  16. Van Arsdell GD, Maharaj GS, Tom J, et al. What is the optimal age for repair of tetralogy Fallot? Circulation 2000;102(Suppl. 3):III-123-III-129.

  17. Presbitero P, Somerville J, Stone S, et al. Pregnancy in cyanotic congenital heart disease. Outcome of mother and fetus. Circulation 1994;89:2673-2676.

  18. Iñigo RCA, Torres GLG, Hernández HS, Gómez VJR. Anomalía de Ebstein y embarazo. Ginecol Obstet Mex 2008;76(8):461-467.

  19. Torres GLG, Iñigo RCA, Espinoza OMA, Barba BAM. Embarazo en pacientes con ventrículo único con y sin corrección quirúrgica. Ginecol Obstet Mex 2007;75(10):630-635.

  20. Koos BJ. Management of uncorrected, palliated and repaired cyanotic congenital heart disease in pregnancy. Progress in Pediatric Cardiology 2004;19:25-45.




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