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      Fertility, Pregnancy and Delivery in Women after Biventricular Repair for Double Outlet Right Ventricle

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          Objectives: To investigate outcome of pregnancy and fertility in women with double outlet right ventricle (DORV). Methods: Using 2 congenital heart disease registries, 21 female patients with DORV (aged 18–39 years) were retrospectively identified. Detailed recordings of each patient and their completed (>20 weeks gestation) pregnancies were recorded. Results: Overall, 10 patients had 19 pregnancies, including 3 spontaneous miscarriages (16%). During the 16 live birth pregnancies, primarily (serious) noncardiac complications were observed, e.g. premature labor/delivery (n = 7 and n = 3, respectively), small for gestational age (n = 4), preeclampsia (n = 2) and recurrence of congenital heart disease (n = 2). Except for postpartum endocarditis and deterioration of subpulmonary obstruction, only mild cardiac complication pregnancies were recorded. Two women with children reported secondary female infertility. Several menstrual cycle disorders were reported: secondary amenorrhea (n = 4), primary amenorrhea (n = 3) and oligomenorrhea (n = 2). Conclusion: Successful pregnancy in women with DORV is possible. Primarily noncardiac complications were observed and only few (minor) cardiac complications. Infertility and menstrual cycle disorders appear to be more prevalent.

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          Most cited references 6

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          Pregnancy and its outcome in women with and without surgical treatment of congenital heart disease.

          In the state of Connecticut, 233 women with congenital heart defects were prospectively followed up through 482 pregnancies that resulted in 372 infants who were examined frequently during their first 3 years of life. Approximately half of the women had undergone cardiac surgery and they were compared with the women without operation. There was no maternal mortality, and no patient had infective endocarditis, brain abscess or a cerebrovascular accident. The proportion of pregnancies resulting in live births did not differ significantly in mothers with and without cardiac surgery; the average live birth rate was 77 percent in all. However, the number and size of live-born infants was much greater in mothers who had become acyanotic as a result of reparative surgery than in the still cyanotic women, whether or not they had had palliative surgery. In cyanotic women, placental size was abnormally large in relation to birth weight, which was abnormally low. When the mothers were classified according to cardiac function, there was a significant difference between the number of infants born alive to mothers in good to excellent status and the number born to mothers in fair to poor condition. The latter had a significant increase in interrupted pregnancies as well as in cardiovascular complications during pregnancy. The total group had a 16.1 percent incidence rate of infants with congenital heart disease. This rate was corrected to 14.2 percent by removal of seven mothers, two with Noonan's syndrome, one with hypertrophic cardiomyopathy and four with a family history of congenital heart defects.
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            Risk of complications during pregnancy after Senning or Mustard (atrial) repair of complete transposition of the great arteries.

            To investigate magnitude and determinants of risks during pregnancy in women with Mustard or Senning repair for complete transposition of the great arteries (TGA).
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              • Abstract: not found
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              Cardiac complications relating to pregnancy and recurrence of disease in the offspring of women with atrioventricular septal defects


                Author and article information

                S. Karger AG
                January 2008
                14 August 2007
                : 109
                : 2
                : 105-109
                Departments of aCardiology, bObstetrics and Gynaecology and cThoracic Surgery, University Medical Center Groningen, Groningen, dDepartment of Cardiology, Erasmus Medical Center, Rotterdam, eDepartment of Cardiology, Academic Medical Center, Amsterdam, fDepartment of Cardiology, St. Radboud University Medical Center, Nijmegen, and gDepartment of Cardiology, Leiden University Medical Center, Leiden, The Netherlands; hDepartment of Cardiology, University Hospitals Leuven, Leuven, Belgium
                105550 Cardiology 2008;109:105–109
                © 2007 S. Karger AG, Basel

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                Tables: 2, References: 11, Pages: 5
                Original Research


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