Case reports

The peripartum management of a 32-year-old patient presenting at 34 weeks’ gestation with unrepaired cyanotic heart disease

J N Rossouw, E Langenegger, J Burke, A Van Rensburg, A Pecoraro

Abstract


Unrepaired cyanotic heart disease is considered a high-risk lesion owing to the consequent increase in maternal and fetal complications. In the presence of pulmonary hypertension, maternal mortality approaching 50% has been reported, and pregnancy is therefore considered contraindicated. We present a case of a 32-year-old woman presenting at 34 weeks’ gestation in heart failure due to newly diagnosed cyanotic complex cardiac disease. The diagnosis of left atrial isomerism with a common atrium, single atrioventricular valve, and a restrictive ventricular septum defect was made. Cyanosis was due to mixing at atrial level, without features of Eisenmenger’s syndrome. Her intrapartum multidisciplinary management is described in detail. The patient was discharged home in a condition similar to her baseline, together with her healthy neonate.


Authors' affiliations

J N Rossouw, Department of Obstetrics and Gynaecology, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

E Langenegger, Department of Obstetrics and Gynaecology, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

J Burke, Department of Obstetrics and Gynaecology, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

A Van Rensburg, Department of Cardiology, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

A Pecoraro, Department of Cardiology, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

Full Text

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Keywords

Pregnancy; Congenital cardiac disease, Critical care

Cite this article

South African Journal of Obstetrics and Gynaecology 2018;24(2):36. DOI:10.7196/sajog.1265

Article History

Date submitted: 2017-10-06
Date published: 2018-12-03

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