Pregnancy outcomes in women with Ebstein's anomaly.

Objectives: To evaluate whether women with Ebstein's anomaly can tolerate pregnancy and whether the perinatal outcomes are influenced by the severity of Ebstein's anomaly.

Methods: Data of four women with Ebstein's anomaly delivered in our unit were collected and analyzed retrospectively.

Results: (1) Two women with Ebstein's anomaly had uneventful pregnancies, cesarean section and puerperium. (2) The patient with the most serious Ebstein's anomaly (with central cyanosis and clubbing) had an episode of paroxysmal ventricular tachycardia and spontaneous cardioversion to sinus rhythm on day 4 postpartum. She developed intracerebral hemorrhage on day 25 postpartum. (3) One of them suffered from atrial flutter on 38 + 3 weeks of gestation which was restored to sinus rhythm after being treated with verapamil and remained stable afterward. (4) All neonatal birth weights were more than 2,500 g, and all neonatal Apgar scores were 10 at 1 min. (5) The gestational age at delivery of our cases was from week 36 + 4 to week 38 + 4. The mean duration of follow-up was 56 days postpartum.

Conclusions: (1) The clinical features of pregnant women with Ebstein's anomaly vary. They might have good perinatal outcomes when given appropriate treatment. (2) Those with cyanosis should be given more attention, as they can have more complications during pregnancy, delivery and puerperium. (3) All women with Ebstein's anomaly should be offered fetal echocardiography during pregnancy. (4) Vaginal delivery is advised for most cases with Ebstein's anomaly.