Ebstein Anomaly in Pregnancy

Area of Science:

• Cardiology
• Maternal-Fetal Medicine
• Congenital Heart Disease

Background:

• Ebstein's anomaly is a rare congenital heart defect impacting the tricuspid valve.
• Management in pregnancy requires careful consideration due to potential maternal and fetal risks.
• Untreated severe forms can lead to significant maternal morbidity, including heart failure.

Observation:

• A 27-year-old primiparous woman presented at 28 weeks gestation with progressive dyspnea.
• She had a history of untreated Ebstein's anomaly, diagnosed three years prior.
• Echocardiography revealed Ebstein's anomaly with patent foramen ovale, left ventricular and atrial dilatation, severe tricuspid regurgitation, and moderate pulmonary hypertension.

Findings:

• The patient's worsening symptoms necessitated a decision regarding pregnancy management.
• An elective cesarean section was performed at 30 weeks gestation.
• Both mother and neonate had favorable outcomes post-delivery.

Implications:

• This case highlights the importance of timely intervention in pregnant patients with complex congenital heart disease.
• Early diagnosis and multidisciplinary management are crucial for optimizing outcomes in Ebstein's anomaly during pregnancy.
• Cesarean delivery can be a safe option for selected cases, even preterm, when maternal condition deteriorates.