Key result
Uncorrected tetralogy of Fallot in pregnant women was associated with a significantly higher rate of prematurity (50% vs 5.26%) compared to those with prior surgical repair.
Why the study?
Tetralogy of Fallot confers substantial risk to mother and fetus, but pregnancy outcomes in women with TOF have not been well studied.
Does surgical repair of tetralogy of Fallot improve maternal and perinatal outcomes in pregnant women compared to uncorrected TOF?
Observational (n=31)
No
Does surgical repair of tetralogy of Fallot improve maternal and perinatal outcomes in pregnant women compared to uncorrected TOF?
Absolute Event Rate: 50% vs 5.26%
p-value: p=0.007
Pregnant women with uncorrected tetralogy of Fallot face significantly higher risks of obstetric and cardiac complications, including preterm birth and fetal/neonatal mortality, compared to those with surgically repaired TOF.
May support pre-pregnancy TOF repair to lower preterm birth risk; observational data leave open causal confirmation.
Background Ttralogy of Fallot (TOF) is a severe type of congenital heart disease (CHD) and confers substantial risk to mother and fetus. However, the outcomes of pregnant women with TOF have not been well studied.Methods Women with TOF who has been seen and/or delivered at our tertiary-care hospital between April 2008 and January 2018 were retrospective reviewed.Results A total of 31 TOF patients with pregnancies were identified in ten-year period. Among these patients, cardiac defects were surgically repaired in 19 cases and remained uncorrected in 12 women. The frequency of miscarriages and preterm birth was greater in the uncorrected group (16.67% vs one, and 50% vs 5.26%, respectively). The percentage of babies who were small for gestational age (SGA) was 41.67% and 10.53% in two groups. The neonatal mortality and fetal mortality were observed in women without correction for TOF, which were 3.23% (1/31) and 6.45(2/31), respectively. Maternal and neonatal risk appeared to be associated with heart functional classifications, pulmonary hypertension and histories of cardiac events such as serious cardiac arrhythmias.Conclusions Obstetric and cardiac complications are more frequently present in the pregnant women with uncorrected TOF. Surgical correction is associated with improved maternal and perinatal outcome.
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Wang et al. (2019) conducted an observational in Tetralogy of Fallot in pregnancy (n=31). Uncorrected tetralogy of Fallot vs. Surgically repaired tetralogy of Fallot was evaluated on Prematurity (p=0.007). Uncorrected tetralogy of Fallot in pregnant women was associated with a significantly higher rate of prematurity (50% vs 5.26%) compared to those with prior surgical repair.
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