Clinical Analysis of Eleven Pregnancies with Transposition of Great Arteries / 实用妇产科杂志

ABSTRACT

Objective:To analyze the management and outcome of pregnant woman with transposition of great arteries and to investigate the effect of multidisciplinary management during pregnancy on the pregnancy outcome.Methods:The clinical data of 11 pregnant women with transposition of great arteries under going treatment in Beijing Anzhen Hospital during January 2007 and December 2017 was studied retrospectively.The cardiac function, cardiac index, management during pregnancy and outcomes were assessed.Results:Eight patients (No.1～No.8) were complicated with corrected transposition of the great arteries (CTGA).one (No.9) was complicated with complete transposition of the great arteries (TGA).Two were complicated with double outlet right ventricle (DORV).Enlargement of left atrial enlargement and increase of left functional ventricular diameter were observed in all eight patients with CTGA.The left atrioventricular valve regurgitation was reported in these patients except the patient No.7 who had a mechanical valve replacement.Three cases had elevated BNP.Patient No.9 who was with TGA showed an enlargement of the right heart and a narrow inner diameter of left heart.Fetal death occurred in second trimester.The left ventricular enlargement, BNP elevation and atrioventricular valve regurgitation were observed in the two patients with DORV.The mean pregnancy length was 34.6±5.0 weeks.Nine had cesarean deliveries.One received cesarean section with fetal death.One had vaginal delivery.Average hemorrahge volume was 245±110 ml.One was fetal loss with cesarean section, while six were term delivery, and the other four cases were premature delivery.All eleven patients were discharges with an average hospitalization days 9.4±4.2 days.The average weight of fetus was 2659±1012 g.Three were low birth weight infants.Two newborns had mild asphyxia.No birth defects or fetal complications were reported.Conclusions:Pregnancy could be attempted in CTGA patients with normal cardiac function, no obvious cardiac valve regurgitation orventricular enlargement.They should be followed by multidisciplinary management during pregnancy.It is pregnancy contraindication for woman with TGA and DORV without surgical treatment.