Abstract：
Background Information on maternal and fetal outcomes of pregnancy in women with D-transposition of the great arteries is limited. We conducted a systematic literature review on pregnancies in women with transposition of the great arteries after atrial and arterial switch operations to better define maternal and fetal risk. Methods and Results A systematic review was performed on studies between 2000 and 2021 that identified 676 pregnancies in 444 women with transposition of the great arteries. A total of 556 pregnancies in women with atrial switch operation were tolerated by most cases with low mortality (0.6%). Most common maternal complications, however, were arrhythmias (9%) and heart failure (8%) associated with serious morbidity in some patients. Worsening functional capacity, right ventricular function, and tricuspid regurgitation occurred in ≈20% of the cases. Rate of fetal and neonatal mortality was 1.4% and 0.8%, respectively, and rate of prematurity was 32%. A total of 120 pregnancies in women with arterial switch operation were associated with no maternal mortality, numerically lower rates of arrhythmias and heart failure (6% and 5%, respectively), significantly lower rate of prematurity (11%; P<0.001), and only 1 fetal loss. Conclusions Pregnancy is tolerated by most women with transposition of the great arteries and atrial switch operation with low mortality but important morbidity. Most common maternal complications were arrhythmias, heart failure, worsening of right ventricular function, and tricuspid regurgitation. There was also a high incidence of prematurity and increased rate of fetal loss and neonatal mortality. Outcome of pregnancy in women after arterial switch operations is more favorable, with reduced incidence of maternal complications and fetal outcomes similar to women without underlying cardiac disease.
摘要：
背景关于大动脉D转位妇女妊娠的母体和胎儿结局的信息有限。我们对心房和动脉转换手术后大动脉转位的孕妇进行了系统的文献综述，以更好地定义母体和胎儿的风险。方法和结果对2000年至2021年的研究进行了系统评价，该研究确定了444例大动脉转位妇女中的676例怀孕。大多数低死亡率（0.6％）的病例可以耐受进行心房转换手术的妇女总共556例妊娠。最常见的产妇并发症，然而,在某些患者中，心律失常（9％）和心力衰竭（8％）与严重发病率相关。功能能力恶化，右心室功能,三尖瓣反流发生在约20%的病例中。胎儿和新生儿死亡率分别为1.4%和0.8%,分别,早产率为32%。共有120例接受动脉转换手术的妇女怀孕与无孕产妇死亡相关，心律失常和心力衰竭的数值较低(6%和5%，分别)，早产率显着降低（11％；P<0.001），只有1个胎儿丢失。结论大多数大动脉转位和心房开关手术的妇女可以耐受妊娠，死亡率低，但发病率高。最常见的产妇并发症是心律失常，心力衰竭,右心室功能恶化，和三尖瓣反流.早产的发生率也很高，胎儿丢失率和新生儿死亡率增加。动脉转换手术后妇女的妊娠结局更有利，与没有基础心脏病的妇女相似，母亲并发症和胎儿结局的发生率降低。
