Outcomes of pregnancy in women with tetralogy of Fallot.

Anaesthesia and Intensive Care, Skejby Hospital, Aarhus UniversityHospital, Aarhus, DenmarkAbstract Background: Surgical results after repair of tetralogy of Fallot have remained excellent for the lastdecades, with current long-term rates of survival over 95%. Since functional capacity, quality of life, and socialinteractions are basically normal in this large group of patients, pregnancy obviously becomes a relevant issuefor the female subgroup. In consequence, adequate obstetrical and cardiological management of pregnancy isparticularly important. Objective: To describe the outcomes of pregnancy, and fertility, in a series of womenwho underwent surgery for tetralogy of Fallot in a single centre. Methods and results: We obtained data fromhospital records, national registries, and questionnaires on 78 women who underwent surgical correction oftetralogy of Fallot between 1972 and 1992. Of 58 women who reached an age of at least 18 years, with 45 ofthis cohort currently surviving, 13 having died as adults, there were 54 pregnancies in 25 women. Therecorded rate of spontaneous abortion was 15%, and infertility rate was 3.4%. There have been 41 life births,with a median weight at birth of 3.2kg. Only 1 newborn was small for gestational age, and no one was bornbefore the 36th week. The recurrence rate of congenital heart disease was high, at 9.8%. Cardiac complicationsduring or after pregnancy were not observed, and only one woman had pre-eclampsia. Conclusions: Pregnancyis well tolerated in women with tetralogy of Fallot, and an excellent neonatal outcome is expected. Therecurrence risk of congenital cardiac disease, most often tetralogy of Fallot, is high.