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Cyanotic Lesions

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Pregnancy and Congenital Heart Disease

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

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Abstract

Due to the fact that early childhood repair is now available for almost all forms of cyanotic heart defects, the number of adult women of childbearing age with unrepaired cyanotic defects is constantly decreasing. Adults with unrepaired cyanotic heart defects are, however, a vulnerable patient group with a high risk of morbidity and a high risk of premature death as young adults. The risk of cardiovascular complications during pregnancy and peripartum is high in women with unrepaired cyanotic heart defects. Thorough pre-pregnancy assessment with an aim to identify potential targets for improvement and to allow appropriate risk stratification is important. The offspring risk in women with unrepaired cyanotic heart defects is very high, with premature delivery in more than 40% and low birth weight for gestational age being the most common complications. Successful pregnancies in women with resting oxygen saturation below 85% in room air are exceedingly rare. Detailed pre-pregnancy counselling will enable informed-decision making in affected women. Pregnant women with cyanotic heart defects must be managed by an experienced multi-disciplinary team at a tertiary care centre. The multidisciplinary team should include dedicated cardiologists, high-risk obstetricians and obstetric anaesthetists along with other specialists as needed. A particular emphasis should be put on minimizing preventable complications, such as paradoxical embolism by the use of meticulous thromboembolic prophylaxis at times of increased risk and the use of air bubble filters for all intravenous lines.

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Abbreviations

SpO2 :

Transcutaneous oxygen saturation

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Acknowledgements

We wish to thank Prof. Jack M. Colman for the thorough review of the manuscript.

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Authors and Affiliations

  1. University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland

    Matthias Greutmann MD

  2. Department of Cardiology, University Hospital Basel, Basel, Switzerland

    Daniel Tobler MD

Authors
  1. Matthias Greutmann MD
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  2. Daniel Tobler MD
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Corresponding author

Correspondence to Matthias Greutmann MD .

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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Greutmann, M., Tobler, D. (2017). Cyanotic Lesions. 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_16

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  • DOI: https://doi.org/10.1007/978-3-319-38913-4_16

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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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