Pregnancy outcome following Mustard procedure for transposition of the great arteries: a report of five cases and review of the literature

Abstract

Objective: To review outcomes and complications of pregnancies in women with transposition of the great arteries who had undergone the Mustard procedure.

Methods: Four women with transposition of the great arteries who had undergone Mustard procedures in childhood received their obstetric care for five pregnancies at three institutions in the greater Philadelphia area between 1990-1992. Pregnancy complications and outcomes were reviewed.

Results: The most common maternal complication in pregnancy following performance of the Mustard procedure was cardiac arrhythmia, which required treatment in two of four patients. Late-onset fetal growth restriction requiring induction occurred in two of five pregnancies. Third-trimester oligohydramnios requiring induction occurred in one patient, and her second pregnancy was complicated by preterm labor and premature rupture of the membranes (PROM) at 33 weeks. One patient with a twin pregnancy developed mild preeclampsia, preterm labor, and PROM at 30 weeks. There were no neonatal or perinatal deaths or significant morbidity.

Conclusion: If a patient with transposition of the great arteries who underwent the Mustard procedure is hemodynamically stable before pregnancy, good maternal and fetal outcome can be expected.