Key result
Maternal repaired tetralogy of Fallot was associated with higher rates of antenatal complications (30% vs 13%) and lower mean birthweight centile (26 vs 58, P=0.000001) compared to controls.
Why the study?
Does repaired tetralogy of Fallot affect maternal and neonatal outcomes compared to control pregnancies?
Cohort (n=130)
No
Does repaired tetralogy of Fallot affect maternal and neonatal outcomes compared to control pregnancies?
Absolute Event Rate: 30% vs 13%
Women with repaired tetralogy of Fallot have higher rates of antenatal complications and deliver infants with lower birthweight centiles, particularly in the presence of moderate to severe pulmonary regurgitation.
May support intensified antenatal surveillance; leaves open causal drivers and management trials in repaired tetralogy of Fallot.
We performed a retrospective cohort study of 26 pregnancies in 16 women with repaired tetralogy of Fallot (rTOF) delivering at the Chelsea and Westminster Hospital and compared them with 104 controls. The rate of antenatal complications was significantly higher in the rTOF group (30 cf. 13%). Use of epidural anaesthesia was higher (67 cf. 25%) in the rTOF group compared with controls, and the length of the second stage was shorter in both spontaneous and assisted deliveries. However, the mode of delivery and neonatal outcomes were similar in both groups. Mean birthweight centile was lower in the tetralogy of Fallot group, 26 versus 58 in the control group (P = 0.000001, Wilcoxon rank sum test). All women whose babies were <10th centile weight for gestational age had moderate to severe pulmonary regurgitation.
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Gelson et al. (2008) conducted a cohort in Repaired tetralogy of Fallot (n=130). Repaired tetralogy of Fallot vs. Controls without tetralogy of Fallot was evaluated on Antenatal complications. Maternal repaired tetralogy of Fallot was associated with higher rates of antenatal complications (30% vs 13%) and lower mean birthweight centile (26 vs 58, P=0.000001) compared to controls.
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