Document Detail

Successful pregnancies in two women with hypoplastic left heart syndrome.
MedLine Citation:
PMID:  21087437     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Hypoplastic left heart syndrome (HLHS) is a relatively common complex congenital heart defect. Prior to development of staged reconstruction (i.e., Norwood procedure), HLHS was almost universally fatal within months of birth. Early survivors of the Norwood procedure are now reaching reproductive age. We report successful pregnancies in two such women.
PATIENTS: The first patient was a 20-year-old woman transferred from a community hospital at 33 3/7 weeks gestation because of preterm labor, suspected preeclampsia, and mild chronic hypoxemia. She had normal systemic ventricular shortening without significant valvar regurgitation but severe neoaortic dilatation. A fetal ultrasound demonstrated intrauterine growth restriction. An urgent Cesarean section was performed at 33 6/7 weeks gestation, given breech position and intractable preterm labor. The second patient, a 23-year-old woman followed at this institution through pregnancy, presented with preterm labor at 36 weeks gestation. Her systemic ventricular shortening was normal, with mild tricuspid regurgitation but without neoaortic dilation or regurgitation. She developed active labor at 36 3/6 weeks, and had a spontaneous vaginal delivery of a small for gestational age infant. Both women tolerated labor and childbirth without complication. Neither infant had evidence of structural heart disease on fetal echocardiography or physical examination.
CONCLUSIONS: These cases, the first reported successful pregnancies in mothers with HLHS, highlight the challenges of pregnancy among women with complex congenital heart disease in general and raise several considerations specific to HLHS.
Alexander R Opotowsky; Deborah Shellenberger; Vanita Dharan; Emmanuelle Paré; William I Norwood; Gary D Webb; Richard Donner
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  5     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-11-22     Completed Date:  2011-03-04     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  476-81     Citation Subset:  IM    
Department of Cardiology, Children's Hospital Boston, 300 Longwood Avenue, Bader 209, Boston, MA 02115, USA.
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MeSH Terms
Breech Presentation / etiology
Cesarean Section
Fetal Growth Retardation / etiology
Gestational Age
Hypoplastic Left Heart Syndrome* / complications,  pathology,  surgery
Live Birth*
Magnetic Resonance Imaging
Norwood Procedures
Obstetric Labor, Premature / etiology
Pregnancy Complications, Cardiovascular* / pathology,  surgery
Young Adult

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