Pregnancy among women with congenitally corrected transposition of great arteries

OBJECTIVES The outcome of pregnancy in congenitally conected transposition of the seat vessels was studied in 22 women. BACKGROUND Women with congenitally corrected transposition of the great ves sels often reach childbearing age. Although reports on the outcome of pregn ancy in these women are available, the number of patients is small. METHODS The medical and surgical databases at the Mayo Clinic were reviewed , and 36 women >16 years old with congenitally corrected transposition of t he great vessels were identified. All of them were contacted, and 22 who ha d pregnancies were identified and the outcome of pregnancy was evaluated. RESULTS Twenty-two women had 60 pregnancies resulting in 50 live births (83 %). Forty-four deliveries (88%) were vaginal and 6 (12%) were by cesarean s ection. One delivery was premature at 29 weeks. There was one successful tw in pregnancy. There were 11 unsuccessful pregnancies. One patient developed congestive heart failure late in pregnancy because of systemic atrioventri cular valve regurgitation and required valve replacement in the early postp artum period. One patient had a total of 12 pregnancies, including 1 twin p regnancy and 2 unsuccessful pregnancies. She had multiple pregnancy-related complications, including toxemia, congestive heart failure,endocarditis an d myocardial infarction (single coronary artery). No other serious pregnanc y;related maternal complications and no pregnancy-related deaths occurred. The mean birth weight of the infants (n = 32) was 3.2 +/- 0.4 kg. None of t he 50 live offspring have been diagnosed with congenital heart disease. CONCLUSIONS Successful pregnancy can be achieved in most women with congeni tally corrected transposition of the great arteries. The rate of fetal loss and maternal cardiovascular morbidity is increased. Because of the small n umber of births, the risk of congenital heart disease in offspring of women with congenitally corrected transposition of the great arteries is uncerta in. (C) 1999 by the American College of Cardiology.