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March 26, 2019Obstetric MedicineOpen Access

Atrial switch operations were associated with a significantly higher rate of small for gestational age babies compared to arterial switch operations (66% vs 20%, p=0.013).

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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?

Population

48 completed pregnancies in 23 women with surgically corrected TGA

Comparison

Atrial switch (38 pregnancies) vs arterial switch operation (10 pregnancies)

Design

Retrospective single tertiary referral centre study

Key result

Atrial switch operations were associated with a significantly higher rate of small for gestational age babies compared to arterial switch operations (66% vs 20%, p=0.013).

Authors

AFAnna Fabre‐GraySCStephanie CurtisJTJohanna Trinder

Discussion

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Member takes

Overview

Supports individualized obstetric planning by TGA repair type; leaves open causality and generalizability in larger cohorts.

Study Design

Type

Cohort (n=23)

Multicenter

No

Structured PICO

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?

P
Population
23 women with surgically corrected transposition of the great arteries (48 completed pregnancies) managed at a single tertiary referral clinic between 1997 and 2017.
E
Exposure
Atrial switch procedure (n=38 pregnancies)
C
Comparator
Arterial switch procedure (n=10 pregnancies)
O
Outcome
Obstetric outcomes, specifically pre-term delivery rate and small for gestational age (SGA)hard clinical

Main Result

Absolute Event Rate: 66% vs 20%

p-value: p=0.013

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.

Cite This Study

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 significantly higher rate of small for gestational age babies compared to arterial switch operations (66% vs 20%, p=0.013).

synapsesocial.com/papers/6a205dae2b9ba068dd5ace54https://doi.org/10.1177/1753495x19825964
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Outcome of Pregnancy in Women With D‐Transposition of the Great Arteries: A Systematic Review2022 · 12 citations
  2. 2Pregnancy Outcomes in Women With Transposition of the Great Arteries After an Arterial Switch Operation2018 · 22 citations
  3. 3Pregnancy following Mustard or Senning correction of transposition of the great arteries: a retrospective study2015 · 38 citations
  4. 4Long-term morbidity and quality of life after surgical repair of transposition of the great arteries: atrial versus arterial switch operation2011 · 54 citations
  5. 5Pregnancy in a Patient with Congenital Complete Transposition of Great Arteries after Atrial Switch Operation: A Case Report with a Review of Literatures2018