DOI: 10.36347/sjmcr.2015.v03i04.010

Pages: 317-318

Tetralogy of Fallot is the most common cyanotic congenital heart disease & accounts for 5-6% of congenital heart malformation. Its tetrad of ventricular sepatiental defect,aortic override,infundibular obstruction & right ventricular hypertrophy. We report a rare case of successful pregnancy outcome in a woman with uncorrected tetralogy of Fallot. 23 year old female k/c/o Tetralogy of Fallot diagnosed in childhood came for safe confinement to ANC out-patient in 12th week of pregnancy. She was married 18 months prior with 1 MTP done due to heart disease. Her LMP was 14/5/11 with previous regular cycles. Her 2-D Echo was s/o Tetralogy of Fallot with pulmonary atresia with PDA with collaterals with EF of 60%. Fetal echo was done & was found to be normal. At 26th week patient was admitted. On examination patient had peripheral cyanosis with clubbing. Patient was advised to maintain hydration & was given intermittent oxygen therapy. Patient was monitored regularly. Pregnancy is rarely seen in uncorrected TOF owing to shortened life expectancy as well as decreased fertility. Risk factors that worsen pregnancy include pre-pregnancy hematocrit exceeding 65%, a history of congestive cardiac failure or syncope, cardiomegaly, Right ventricular pressure exceeding 120 mm of Hg or oxygen saturation less than 80%. The likelihood of favorable outcome in mother with TOF depends upon functional cardiac capacity of mother before pregnancy, other complications that further increase cardiac load, quality of medical care provided throughout pregnancy & surgical correction of anomaly before conception.