Pregnancy Outcome in Cases of Uncorrected Tetralogy of Fallot: Case Series with Review of Literature

Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases (CHD), which presents with classical tetrad ventricular septal defect (VSD) with overriding aorta, pulmonary stenosis, and right ventricular hypertrophy.Women with uncorrected TOF have maternal hypoxemia with miscarriage, poor fetal growth, preterm delivery, or even fetal death with chances of maternal heart failure as its consequence event.We are reporting three cases of pregnancy in women having uncorrected TOF who were managed successfully at our institute.Pregnant women with class III-IV NYHA are counseled for MTP, as done in the third case here.However, if the patient refuses, we can proceed with the pregnancy with total bed rest and supportive care, as done in the first two cases.Intense monitoring is required throughout pregnancy as hypoxia and polycythemia both are related to poor maternal and fetal outcomes.Our findings in all three cases were comparable to published cases and studies like done by Veldtman et al., Balci et al., and Drenthen et al.So, patients with TOF during pregnancy need multidisciplinary team care consisting of obstetricians, cardiologists, anesthesiologists, and neonatologists among others.At the initial booking itself, these high-risk patients should be admitted for evaluation of the severity of TOF and its effect on pregnancy.