Management of uncorrected, palliated, and repaired cyanotic congenital heart disease in pregnancy

摘要: Abstract Women with cyanotic congenital heart disease reduced cardiac reserve have decreased ability to tolerate the cardiovascular demands of pregnancy, labor and delivery accommodate pregnancy complications, such as preeclampsia hemorrhage. The most commonly encountered disorder is tetralogy Fallot. Unoperated women this a mortality rate 3–12% high perinatal loss, but outcomes in who had complete repairs are nearly same for normal population. 30% maternal Eisenmenger syndrome largely due inability relatively fixed pulmonary vascular resistance adjust puerperium. Inhaled local vasodilators, nitric oxide or aerosolized prostacyclin, show promise treatment hypertension right failure disorder. atrial switch repair dextro-transposition great arteries, which can be associated functional deterioration systemic morphologic ventricle, generally results good outcome mother fetus. Fontan complex single-ventricle physiology has also been outcome, although spontaneous abortion may increase. Cervical ripening techniques, carefully titrated neuraxial anesthesia, pulse oximetry made safer unrepaired palliated repaired disorders residual cyanosis. Pregnancy high-risk low-prevalence conditions would likely improved further if national registry assess standardized management was established.