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Review
. 2024 Mar 14;20(2):24-35.
doi: 10.14797/mdcvj.1306. eCollection 2024.

High-Risk Congenital Heart Disease in Pregnancy

Saurabh Rajpal  1   2 , Carla P Rodriguez  2   3
Affiliations
Review

High-Risk Congenital Heart Disease in Pregnancy

Saurabh Rajpal et al. Methodist Debakey Cardiovasc J. .

Abstract

High-risk congenital heart disease (CHD) in pregnancy presents a complex clinical challenge. With improved medical care and increased survival rates, a growing population of adults with complex CHD are surviving to adulthood, including women of reproductive age. This chapter focuses on risk stratification and management of pregnant women with high-risk CHD, emphasizing the importance of considering both anatomical and physiological complexity. Maternal physiological changes, such as blood volume increase, cardiac output changes, and alterations in vascular resistance, can significantly impact high-risk CHD patients. Management of high-risk CHD in pregnancy necessitates a multidisciplinary approach and individualized care.

Keywords: Fontan circulation; cardiac risk stratification in pregnancy; complex congenital heart disease; cyanotic congenital heart disease; systemic right ventricle.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

D-loop transposition of great arteries: (top) at birth; (bottom) after arterial switch
Figure 1
(Top) D-Loop transposition of great arteries; (Bottom) D-Loop transposition of great arteries, post arterial switch operation. Courtesy of Bruce Blausen (2014); WikiJournal of Medicine. RA: right atrium; RV: right ventricle; PA: pulmonary artery; Ao: aorta; LA: left atrium; LV: left ventricle
Congenitally corrected transposition of great arteries
Figure 2
Congenitally corrected transposition of great arteries. Image Courtesy of the Adult Congenital Heart Association. RA: right atrium; RV: right ventricle; PA: pulmonary artery; Ao: aorta; LA: left atrium; LV: left ventricle; DAo: descending aorta
Diagrams of human heart (left) with tricuspid atresia; (right) after Fontan procedure
Figure 3
(Left) Diagram of the human heart with tricuspid atresia; (Right) Diagram of the human heart after Fontan procedure, via Wikimedia Commons.
Hemodynamic changes in cyanotic patients during pregnancy
Figure 4
Hemodynamic changes in cyanotic patients during pregnancy. SVR: systemic vascular resistance; PVR: pulmonary vascular resistance; GA: gestational age
See this image and copyright information in PMC

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