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Pregnancy and Congenital Heart Disease pp 99–112Cite as

Pregnancy in Repaired Tetralogy of Fallot

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Part of the book series: Congenital Heart Disease in Adolescents and Adults ((CHDAA))

Abstract

Pregnancy in repaired tetralogy of Fallot may be associated with arrhythmia, heart failure and low birthweight babies. Women who have favourable anatomy and underwent uncomplicated repair of tetralogy of Fallot in childhood can expect low risks in pregnancy and good life expectancy. However, higher maternal risk is associated with features such as more complex underlying anatomy and surgical history, residual or postoperative haemodynamically significant lesions and abnormal right or left ventricular function. For selected patients, prepregnancy intervention for the most common lesion, pulmonary regurgitation, may be justified. For women without a family history of congenital heart disease, the risk of vertical transmission is low at around 2-3% unless the patient also has DiGeorge syndrome which will affect 50% of offspring. Elective DiGeorge genetic testing should be offered at precounselling and fetal echocardiography in the antenatal period.

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Abbreviations

CMR:

Cardiovascular magnetic resonance

ECG:

Electrocardiogram

MAPCAs:

Major aortopulmonary collateral arteries

PR:

Pulmonary regurgitation

RA:

Right atrium

RPA:

Right pulmonary artery

RV:

Right ventricle

RVOT:

Right ventricular outflow tract

WHO:

World Health Organisation

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Acknowledgements

Sonya V. Babu-Narayan is supported by an Intermediate Clinical Research Fellowship from the British Heart Foundation (FS/11/38/28864). This project was supported by the NIHR Cardiovascular Biomedical Research Unit of Royal Brompton and Harefield NHS Foundation Trust and Imperial College London. This report is an independent research by the National Institute for Health Research Biomedical Research Unit Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Author information

Authors and Affiliations

  1. Cardiovascular Biomedical Research Unit and Adult Congenital Heart Programme, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK

    Sonya V. Babu-Narayan MB BS, BSc, PhD, FRCP

  2. Department of Echocardiography and Adult Congenital Heart Programme, Royal Brompton Hospital, London, UK

    Wei Li MD, PhD

  3. National Heart and Lung Institute, Imperial College, London, UK

    Wei Li MD, PhD

  4. Adult Congenital Heart Programme, Royal Brompton Hospital, London, UK

    Anselm Uebing MD, PhD

Authors
  1. Sonya V. Babu-Narayan MB BS, BSc, PhD, FRCP
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  2. Wei Li MD, PhD
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  3. Anselm Uebing MD, PhD
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Corresponding author

Correspondence to Sonya V. Babu-Narayan MB BS, BSc, PhD, FRCP .

Editor information

Editors and Affiliations

  1. Erasmus MC University Medical Center, Rotterdam, Gelderland, The Netherlands

    Jolien W. Roos-Hesselink

  2. Chelsea and Westminster Hospital, London, United Kingdom

    Mark R. Johnson

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Babu-Narayan, S.V., Li, W., Uebing, A. (2017). Pregnancy in Repaired Tetralogy of Fallot. In: Roos-Hesselink, J., Johnson, M. (eds) Pregnancy and Congenital Heart Disease. Congenital Heart Disease in Adolescents and Adults. Springer, Cham. https://doi.org/10.1007/978-3-319-38913-4_7

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  • DOI: https://doi.org/10.1007/978-3-319-38913-4_7

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-38911-0

  • Online ISBN: 978-3-319-38913-4

  • eBook Packages: MedicineMedicine (R0)

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