Experience of managing pregnant women with Eisenmenger's syndrome: Maternal and fetal outcome in 13 cases

AIM: To determine maternal and fetal outcomes in patients with Eisenmenger's syndrome (ES) with the therapeutic strategy. MATERIAL & METHODS: The case histories and therapeutic procedures of 13 pregnant women with ES had been reviewed. RESULTS: One case spontaneously aborted before 28 weeks due to intrauterine death, four were taken to cesarean section before 28 weeks and eight (61.5%) survived beyond 28 weeks' gestation before cesarean section. One mother died (92.3% survival), while infant loss was 38.5%. No pregnancy continued to term but eight babies delivered after 28 weeks were born alive, six of the children have normal physical and mental development. CONCLUSIONS: In pregnant women with ES who wish to continue pregnancy, treatment should include: prolonged bedrest, continuous oxygen inhalation, diuretic administration with close hemodynamic monitoring, anticoagulants should be avoided and exact time point selection of cesarean section.