Fertility, pregnancy and delivery in women after biventricular repair for double outlet right ventricle

Willem Drenthen, Petronella G Pieper, Karin van der Tuuk, Jolien W Roos-Hesselink, Elke S Hoendermis, Adriaan A Voors, Barbara J M Mulder, Arie P J van Dijk, Sing C Yap, Hubert W Vliegen, Philip Moons, Tjark Ebels, Dirk J van Veldhuisen
Cardiology 2008, 109 (2): 105-9

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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