Minimally invasive continuous cardiac output monitoring and fluid optimization can safely guide labor and delivery in high-risk patients with congenitally corrected transposition of the great arteries and systemic ventricular dysfunction.
Supports monitored vaginal delivery feasibility in ccTGA with dysfunction; hypothesis-generating and should not yet change practice.
A descriptive case report of the labour and delivery management of a 28-year-old woman who presented with congenitally corrected transposition of great arteries, dextrocardia, systemic ventricular dysfunction and junctional tachycardia. Patients with congenitally corrected transposition have a thin-walled morphological right ventricle as the systemic circulatory pump. The stress of increased cardiac output can lead to congestive heart failure, systemic atrioventricular valve regurgitation and arrhythmias. We used minimally invasive continuous cardiac output monitoring, fluid balance optimization and good maternal pain control to prevent decompensation and achieve vaginal delivery with a good maternal and neonatal outcome.
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Dhir et al. (2015) studied this question.
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