Akhter N, Siraj M M, Habib S A, Debnath R C, Hassan Z, Islam K, Fatema N, Wahiduzzaman M, Khondokar N N, Kadir A M, Nahar J, Haque F, Islam R, Rahman F
Dr Nargis Akhter, Associate Professor, Department of Gynae and Obstetrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Mymensingh Med J. 2020 Jul;29(3):628-632.
This prospective study was done to determine fetomaternal outcomes of pregnancy in women with Tetralogy of Fallot (TOF) and carried out in two centres especially in the care of patients with adult congenital heart disease (CHD) from January 2005 to December 2009. Clinical, haemodynamic and obstetric data were reviewed for pregnant women with TOF. Ten (10) pregnant women were identified in the age range 18 to 47 years. Most of the patients were in the age group of 18 to 27 years, 34 to 36 weeks gestational age (in week) and primi gravida (60%). Right-sided aortic arch (20%) and major anomalies of pulmonary collaterals (30%) were common anomalies anatomical association. Normal vaginal delivery was the mode of delivery (70%) in the majority of the patients. Spontaneous abortions were occurred in 3(30%) patients. Primary maternal cardiac events complicating pregnancies were congestive heart failure (20%), arrhythmias and cardiovascular events (10%). Premature labor (40%) was the most common obstetric complication. Premature birth (40%), fetal demise (20%), neonatal death (10%) and cardiac anomaly at birth (10%) were the offspring complications in the study. Women with TOF can go through pregnancy with a low risk to themselves with frequent treatable complications, but there is a high incidence of miscarriage, premature births and low birth weight. An incidence of congenital anomaly in the fetus is higher than that found in the normal population.
本前瞻性研究旨在确定法洛四联症(TOF)女性患者的母婴妊娠结局,于2005年1月至2009年12月在两个中心开展,尤其关注成人先天性心脏病(CHD)患者的护理。对TOF孕妇的临床、血流动力学和产科数据进行了回顾。共确定了10名年龄在18至47岁之间的孕妇。大多数患者年龄在18至27岁之间,孕周为34至36周,初产妇占60%。常见的解剖学关联异常包括右侧主动脉弓(20%)和肺侧支主要异常(30%)。大多数患者(70%)的分娩方式为正常阴道分娩。3名(30%)患者发生自然流产。妊娠合并的主要母体心脏事件为充血性心力衰竭(20%)、心律失常和心血管事件(10%)。早产(40%)是最常见的产科并发症。早产(40%)、胎儿死亡(20%)、新生儿死亡(10%)和出生时心脏异常(10%)是该研究中的子代并发症。TOF女性患者妊娠时自身风险较低,并发症多可治疗,但流产、早产和低出生体重的发生率较高。胎儿先天性异常的发生率高于正常人群。