Pregnancy, fertility, and recurrence risk in corrected tetralogy of Fallot

• Published in: Heart (British Cardiac Society) Vol. 91; no. 6; pp. 801 - 805
• Main Authors: Meijer, J M, Pieper, P G, Drenthen, W, Voors, A A, Roos-Hesselink, J W, van Dijk, A P J, Mulder, B J M, Ebels, T, van Veldhuisen, D J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.06.2005; BMJ; BMJ Publishing Group LTD; Copyright 2005 by Heart
• Subjects: Abortion, Induced; Abortion, Spontaneous - etiology; Adolescent; Adult; Biological and medical sciences; Cardiology. Vascular system; CONCOR; CONgenital COR vitia; Congenital diseases; Congenital Heart Disease; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Electrocardiography; Female; Heart; Heart Defects, Congenital - genetics; Humans; Infant, Newborn; Infant, Small for Gestational Age; Infertility; Infertility, Female - etiology; Medical sciences; Middle Aged; New York Heart Association; NYHA; Pregnancy; Pregnancy Complications, Cardiovascular - etiology; Pregnancy Outcome; Pregnancy, High-Risk; Premature Birth; tetralogy of Fallot; Tetralogy of Fallot - complications; Tetralogy of Fallot - surgery; Ultrasonic imaging; Recurrence; Relapse; Cardiovascular disease; Risk; Congenital disease; Phlebology; Pregnancy; Fertility; Heart disease; Fallot tetralogy; Risk factor; Circulatory system; Cardiology
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2004.034108

Objective: To determine in women with surgically corrected tetralogy of Fallot the risk of pregnancy for mother and fetus, whether fertility was compromised, and the recurrence risk of congenital heart disease. Design: Data were collected from 83 patients through interviews and review of medical records. Results: In 29 patients 63 pregnancies were observed, of which 13 ended in an abortion. Fifty successful pregnancies were observed in 26 patients. During six successful pregnancies (12%) complications (symptomatic right sided heart failure, arrhythmias, or both) occurred. Both patients who developed symptomatic heart failure had severe pulmonary regurgitation. No clear relation between offspring mortality, premature birth or being small for gestational age, and cardiac characteristics of the mother was identified. Fifty seven patients were childless (41 (72%) voluntarily). Recurrence risk for congenital heart disease was 2.2%. Infertility was uncommon. Conclusions: Although complications did occur in five of 26 (19%) of the patients with a corrected tetralogy of Fallot, pregnancy was generally well tolerated in this largest report so far. No obvious predictors for maternal events or child outcome were determined, except for a possible relation between severe pulmonary regurgitation and symptomatic heart failure.