Pregnancy outcomes and effects on cardiac function among patients with Tetralogy of Fallot: A single-center cohort study

IF 1.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Ohad Houri , Noam Shasho-Peres , Eran Hadar , Sharon Orbach Zinger , Ran Kornowski , Anat Pardo , Shimon Kolker , Shahar Vig , Asnat Walfisch , Bar Narkis , Nili Schamroth Pravda
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Abstract

Background

Data on the characteristics and outcomes of pregnancy amongst patients with Tetralogy of Fallot (TOF) is limited. Depending on the hemodynamic status of the patient, the risk of maternal and fetal complications during pregnancy can be considerable.

Objectives

We aimed to systematically evaluate maternal, obstetric, and fetal outcomes, and assess longitudinal changes in cardiac function among women with TOF using serial imaging.

Methods

Pregnant adult patients with TOF between 2014 and 2022 were included. We examined maternal and obstetric outcomes during pregnancy. We assessed serial imaging to evaluate the temporal effects of pregnancy on cardiac function.

Results

Our cohort included 50 patients. There were 85 pregnancies overall with 79 live births (92.9 %). The median gestational age at delivery was 38.3 [37.0–39.1] gestational weeks (GW), nine deliveries (11.3 %) occurred before 37 GW, but only one before 34 GW. The median birthweight at delivery was 2850 [2450–3048] grams. The main fetal complication was small for gestational age (n = 16,22 %). There were no deaths in the peripartum period or the year following pregnancy. There were no significant valvular or ventricular functional differences when comparing pre-conception to post-conception echocardiogram data. In the subgroup with availability of MRI data, the Right ventricular end-diastolic volume index increased significantly post-pregnancy (109 ± 37.9 ml/m2 vs 117 ± 25.0 ml/m2, p < 0.01).

Conclusions

Maternal and obstetric complications are rare among patients with TOF. Our initial findings suggest that pregnancy does influence cardiac dimensions on serial long-term imaging follow-up but further, expanded long-term data is needed.
法洛四联症患者妊娠结局及对心功能的影响:一项单中心队列研究
背景:关于法洛四联症(TOF)患者妊娠的特点和结局的数据是有限的。根据患者的血流动力学状况,妊娠期间发生母胎并发症的风险可能相当大。目的:我们旨在系统地评估产妇、产科和胎儿结局,并利用序列成像评估TOF妇女心功能的纵向变化。方法选取2014 ~ 2022年妊娠期成人TOF患者。我们检查了怀孕期间的孕产妇和产科结局。我们评估了一系列影像来评估妊娠对心功能的时间影响。结果我们的队列包括50例患者。总共有85例妊娠,79例活产(92.9%)。分娩时的中位胎龄为38.3[37.0-39.1]胎周(GW), 9例(11.3%)分娩在37 GW之前,但只有1例分娩在34 GW之前。分娩时出生体重中位数为2850[2450-3048]克。主要的胎儿并发症是胎龄小(n = 16, 22%)。围产期和妊娠后一年无死亡病例。当比较孕前和孕后超声心动图数据时,没有明显的瓣膜或心室功能差异。在可获得MRI数据的亚组中,妊娠后右心室舒张末期容积指数显著升高(109±37.9 ml/m2 vs 117±25.0 ml/m2, p < 0.01)。结论TOF患者的产妇及产科并发症较少见。我们的初步研究结果表明,妊娠确实会影响连续长期影像学随访的心脏尺寸,但需要进一步扩大长期数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International journal of cardiology. Congenital heart disease
International journal of cardiology. Congenital heart disease Cardiology and Cardiovascular Medicine
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83 days
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