BACKGROUND:

Of every 10,000 newborns there are approximately 4 to 8 cases of structural heart malformation of the single ventricle type. If an adequate balance between systemic and pulmonary circulation is achieved, it is possible to live up to 70 years of age. Pregnancy in patients with this condition can aggravate and decompensate heart disease. There are scales to classify, before conception and during pregnancy, the risk of morbidity-mortality.

OBJECTIVE:

To report the case of complex congenital heart disease and the maternal and fetal outcomes.

CLINICAL CASE:

37-year-old female patient, with a history of the single left ventricle, pregnant 13 times, with 4 cesarean sections and 9 abortions. She was admitted to the high-risk obstetric service at 11.1 weeks of pregnancy for maternal and fetal surveillance. She was counseled about the possible risks derived from pregnancy and her cardiac disease; however, she decided to carry the pregnancy to term. During pregnancy, preserved ejection fraction with deterioration in functional class repeated desaturation, and placental accreta were documented. The pregnancy was terminated at 32.5 weeks and the postoperative course was without major maternal or fetal complications. The newborn remained in intensive care for two months and six months after delivery, the patient had an episode of heart failure decompensation.

CONCLUSIONS:

Potential adverse maternal and fetal outcomes in the setting of complex congenital heart disease can be attenuated with early detection of poor prognostic factors and appropriate preconception counseling.

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