Uncomplicated Pregnancy with Residual Tetralogy of Fallot Post-Surgery

The most common cyanotic congenital heart disease (CHD) in adults is Tetralogy of Fallot (TOF), accounting for 10% of congenital heart anomalies and 75% of cyanotic CHD cases. It is a congenital heart disease that most often requires surgical correction within the first year of life. Corrective surgical treatment for TOF began in the 20th century, starting with a temporary shunt procedure and advancing to primary surgical repair. The current approach in infants often involves valve-sparing techniques. Following corrective surgery, more than 85% of patients with TOF can survive into adulthood. Without repair, however, patients with TOF rarely reach adulthood, and the prognosis for pregnant women with CHD is poor. Congenital heart disease is one of the leading causes of indirect maternal deaths. The literature indicates that pregnant patients with corrected TOF still face a higher risk compared to otherwise healthy women. According to the modified World Health Organization maternal cardiovascular risk classification, patients with repaired TOF have a mild risk of mortality and a moderate risk of morbidity, with the risk of maternal cardiac events ranging from 5.7% to 10.5%. Cardiac evaluations should be performed at least once during each trimester of pregnancy. In this case report, we discuss the pregnancy and successful, uncomplicated birth of a woman with TOF who underwent corrective surgery in childhood.