Maternal and Perinatal Outcomes in Uncorrected Tetralogy of Fallot

Abstract

Background: Tetralogy of Fallot (TOF) is the most common congenital heart disease in the population.
Correction of TOF during infancy or childhood may increase the quality of patient’s life. Uncorrected TOF
may cause further complications later on. Pregnancy with uncorrected TOF may cause complications on
both maternal and fetal sides.
Objective: to analyze maternal and perinatal outcomes in patients with uncorrected TOF during pregnancy.
Methods: This is a retrospective study. A total of 8 pregnant women diagnosed with TOF registered in
the Obstetric-Cardiac unit in 3 years (2016-2018). Medical records were reviewed for clinical assessment,
echocardiography results, and therapy during hospitalization. Patients were contacted by telephone to provide
an obstetric history, including details of pregnancy and delivery. Five of 7 patients able to be contacted, and
home visits were done to evaluate their conditions.
Results: There were 8 pregnant women with uncorrected TOF. Most cases (87,5%) were first diagnosed
during pregnancy and delivery. Intra-Uterine Growth Restriction (IUGR) and abortion (62.5% and 25%,
respectively) were the most obstetric complications. Cardiac complications were cardiogenic shock (12.5%),
thromboembolic (12.5%), and various degree of heart failure (62.5%). The number of Small for Gestational
Age (SGA) was 66.7%. Incidence of congenital heart disease (CHD) in the fetus was 20%. One death case
and 2 abortions from a total of 8 cases were found.
Conclusion: TOF may cause many maternal and fetal complications. The most common maternal
complications are heart failure, cardiogenic shock and thromboembolic, while perinatal complications
include IUGR, SGA and abortion.