| Abstract [eng] |
Background: L-transposition of the great arteries is a rare congenital heart defect. 50 % of patients without associated lesions reach the age of 60 years and reach 40 years if other lesions are present. In recent decades more women with this defect reach child-bearing age and wish to get pregnant. Case presentation: A 21-year-old woman was born with l-transposition of the great arteries, ventricular septal defect, Ebstein abnormality, and diminished ejection fraction of systemic ventricle was seen during a routine consultation with a cardiologist. The patient informed that she is 8 weeks pregnant. The pregnancy was deemed high risk and the patient was advised to terminate it. The patient and her partner refused. During the duration of the pregnancy the patient was seen by a cardiologist and obstetrician. Fetal ultrasounds showed good fetal growth and the patient was feeling well. By the 35th week of pregnancy there was a spike in brain natriuretic peptide. With the concern of acute heart failure, it was recommended to induce the pregnancy with cesarean section. The operation was performed under general anesthesia and a preterm boy was born. The patient was monitored in intensive care and was released home without sign of heart failure 5 days after delivery and remained stable postpartum. Conclusion: Pregnancy with l-transposition of the great arteries is possible but carries additional risks for the mother and the child and requires supervision by an expert team of doctors. Patients with congenital heart disease should be encouraged to perform pre-conception counseling. |
