Ebstein's anomaly and pregnancy: a case report.

Ebstein's anomaly, an uncommon malformation of the tricuspid valve, has an extremely variable natural history, depending on a wide spectrum of pathological features. We here described a case of a patient with Ebstein's anomaly who gave birth to 2 healthy unaffected full-term infants after two successful pregnancies; a third pregnancy miscarried at the 11th week. The anomaly was diagnosed during childhood, was not associated with other cardiac anomalies, cyanosis or preexcitation and the echocardiographic degree of severity was low (grade 1). All of these factors are considered predictors of a good survival and prognosis. During the pregnancies, no arrhythmias, cyanosis or signs of cardiac failure were observed and the patient's NYHA functional class (1) remained unchanged. Our case is the only published case of two successful term pregnancies in Ebstein's anomaly, it confirms the importance of echocardiographic evaluation and that the probability of maternal and neonatal events may be predicted from the baseline characteristics of the mother. Pregnancy is well tolerated in the absence of important maternal cardiomegaly, cyanosis and arrhythmias and in those patients with mild cardiac dysfunction as evaluated at echocardiography and a low NYHA class, but it is associated with an increased risk of abortions and prematurity.