Does a Previous Arterial Switch Procedure Increase Risk for Adverse Pregnancy Outcomes?
BACKGROUND AND PURPOSE:
There are limited data on pregnancy outcomes in individuals who experienced an arterial switch procedure for transposition of great arteries (TGA) early in life
Tutarel et al. (Journal of the American Heart Association, 2020) assessed maternal and fetal outcomes in women with a history of arterial switch procedure
Prospective cohort study
ROPAC (Registry of Pregnancy and Cardiac disease)
Pregnant women with TGA
Repair using arterial switch procedure
A major cardiovascular event defined as a composite of: Maternal death | Supraventricular or ventricular arrhythmias requiring treatment | Heart failure | Aortic dissection | Endocarditis | Ischemic coronary events | Thromboembolic events
41 pregnant women with arterial switch procedure
Mean (SD) age: 26.7 (3.9) years
Cesarean delivery; 46.3%
Emergency cesarean: 15% (none related to cardiovascular complications)
Maternal mortality: 0 cases
Major cardiovascular event incidence: 4.9% (2 women)
Heart failure: 2.4% (1 woman)
Ventricular tachycardia: 2.4% (1 woman)
Fetal loss: 1 case
Neonatal mortality: 0 cases
Most frequent fetal complications
Preterm birth: 17.1%
Low birth weight: 14.6%
Pregnancy outcomes are favorable for women who have undergone a repair for TGA
The authors conclude
“…women after an arterial switch procedure for TGA should be counseled that pregnancy is low risk”
Classifying TGA (repaired and otherwise uncomplicated) as modified WHO risk class II (Small increased risk of maternal mortality or moderate increase in morbidity) seems appropriate | See CMQCC WHO Risk Classes below in ‘Learn More – Primary Sources’ below)
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
NOT ENOUGH CME HOURS
It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan