Key result
Atrial switch operations were associated with a higher rate of small for gestational age babies compared to arterial switch operations.
Why the study?
Atrial or arterial switch operations for transposition of the great arteries can complicate physiological adaptation to pregnancy and adversely affect the fetus.
Does the type of surgical correction (atrial vs. arterial switch) for transposition of the great arteries affect obstetric outcomes such as pre-term delivery and small for gestational age?
Cohort (n=23)
No
Does the type of surgical correction (atrial vs. arterial switch) for transposition of the great arteries affect obstetric outcomes such as pre-term delivery and small for gestational age?
Women with surgically corrected TGA are at high risk for obstetric complications, with small for gestational age babies occurring significantly more often following an atrial switch compared to an arterial switch.
Answers are grounded in this paper and cite their sources.
Supports individualized obstetric planning by TGA repair type; leaves open causality and generalizability in larger cohorts.
Repair of transposition of the great arteries usually involves an atrial switch or arterial switch operation, which can complicate physiological adaptation to the demands of pregnancy and adversely affect the fetus. We retrospectively compared outcomes of 48 completed pregnancies in 23 women with surgically corrected transposition of the great arteries (38 atrial switch/10 arterial switch operation) under joint cardiac-obstetric care in our tertiary referral clinic between 1997 and 2017. Most women delivered vaginally (85%). The pre-term delivery rate was high (atrial switch 39%; arterial switch operation 40%). Small for gestational age occurred in 56% of babies, significantly more in the atrial switch group (66%) than arterial switch operation (20%), p = 0.013. Women with surgically corrected transposition of the great arteries wishing to become pregnant are at high risk of obstetric complications, primarily pre-term delivery and small for gestational age baby. They require more careful ultrasound surveillance beyond 36 weeks’ gestation and/or may benefit from early induction of labour. Trial registration: Text/Not applicable.
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Fabre‐Gray et al. (2019) conducted a cohort in Transposition of the great arteries (TGA) (n=23). Atrial switch operation vs. Arterial switch operation was evaluated on Small for gestational age (p=0.013). Atrial switch operations were associated with a higher rate of small for gestational age babies compared to arterial switch operations.
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