Lahmouz Youssef, Ahchouch Sara, El Mangoub Fatima, Zaimi Achraf, Mouine Najat, Asfalou lIiyasse, Kouach Jaouad, Benyass Aatif
Clinical cardiology department, Cardiology Center, Mohammed V Military Instruction Hospital of Rabat, Mohammed V University, Morocco.
Department of gynecology and obstetrics, Mohammed V Military Instruction Hospital of Rabat, Mohammed V University, Morocco.
Radiol Case Rep. 2023 Apr 7;18(6):2154-2157. doi: 10.1016/j.radcr.2023.02.050. eCollection 2023 Jun.
Complex congenital heart disease and pregnancy are a challenge and delicate medical situation. We describe a first-time pregnancy of a woman living with an uncorrected d-transposition of the great arteries (TGA) with serious fetal complications required multidisciplinary assessment. Twenty-six years old primigravida referred to our cardiology center in 34 weeks of gestation with peripheral cyanosis. The patient was stable hemodynamically and the room air oxygen was at 82%. A continuous murmur systolic and diastolic at second left intercostals space was found. The transthoracic echocardiographic showed an uncorrected TGA with a large atrial defect and patent ductus arteriosus. Obstetrical ultrasonography showed severe intrauterine growth restriction. The patient was delivered by caesarean section under epidural anesthesia with good outcome. This is a case report with discussion of the maternal-fetal outcome of pregnant women with asymptomatic uncorrected TGA. Coordinated care by an informed obstetrician and cardiologist should be the aim.
复杂先天性心脏病与妊娠是一项挑战，也是棘手的医疗状况。我们描述了一名患有未经矫正的大动脉 d 转位（TGA）的女性首次怀孕的情况，该病例出现了严重的胎儿并发症，需要多学科评估。一名 26 岁的初产妇在妊娠 34 周时因外周性发绀转诊至我们的心脏病中心。患者血流动力学稳定，室内空气下血氧饱和度为 82%。在左第二肋间发现连续性收缩期和舒张期杂音。经胸超声心动图显示为未经矫正的 TGA，伴有大型房间隔缺损和动脉导管未闭。产科超声检查显示严重的宫内生长受限。患者在硬膜外麻醉下接受剖宫产，结局良好。这是一篇病例报告，讨论了无症状未经矫正 TGA 孕妇的母胎结局。目标应是由经验丰富的产科医生和心脏病专家进行协调护理。
