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Ebstein's anomaly and pregnancy: a case report
Maura Nataloni1, Roberto Mocchegiani
1Department of Medicine, ASL 6, Fabriano (AN), Italy.
Summary
This case study highlights a woman with Ebstein's anomaly who had two successful full-term pregnancies. Mild cardiac dysfunction and early diagnosis predict a good prognosis for pregnancy in Ebstein's anomaly.
Area of Science:
- Cardiology
- Reproductive Medicine
- Medical Genetics
Background:
- Ebstein's anomaly is a rare congenital heart defect affecting the tricuspid valve.
- Its natural history is highly variable, influenced by diverse pathological features.
- Understanding prognostic factors is crucial for managing affected individuals, especially during pregnancy.
Observation:
- A patient diagnosed with Ebstein's anomaly in childhood, with low echocardiographic severity (grade 1) and no associated anomalies, cyanosis, or preexcitation.
- The patient experienced two successful full-term pregnancies resulting in healthy infants and one early miscarriage.
- Throughout pregnancies, she remained asymptomatic, with unchanged NYHA functional class (1), no arrhythmias, cyanosis, or signs of cardiac failure.
Findings:
- This represents a unique case of two successful term pregnancies in a patient with Ebstein's anomaly.
- Predictors of favorable maternal and neonatal outcomes include mild cardiac dysfunction, absence of cardiomegaly, cyanosis, arrhythmias, and a low NYHA functional class.
- Echocardiographic evaluation is vital for assessing pregnancy risk in Ebstein's anomaly.
Implications:
- Pregnancy can be well-tolerated in selected Ebstein's anomaly patients with favorable baseline characteristics.
- Early echocardiographic assessment aids in predicting maternal and neonatal risks.
- While generally well-tolerated in mild cases, pregnancy in Ebstein's anomaly is associated with increased risks of miscarriage and preterm birth.