[The corse of pregnancy and delivery in patients with surgicaly corrected tetralogy of Fallot].

Twenty-eight pregnancies in 16 patients with surgically corrected tetralogy of Fallot between 1997 and 2002 at the SBALAG "Maichin dom", Sofia, were reviewed. Most of the patients were well and asymptomatic after surgery, excluding one patient who was functional class III. The patients had a total of twenty-one successful pregnancies and deliveries. There were seven abortions (33%) and two small-for-date babies (12%). None of the infants had any cardiac anomalies. The pregnancies were relatively well tolerated and there were no life-threatening cardiac complications. For a patient with some residual abnormalities after surgical correction of tetralogy of Fallot, it is important to reassess the cardiac state before pregnancy and, if once pregnant, to anticipate the possible occurrence of complications during labor. Compared to the general obstetric population, more women in the study group underwent instrumental vaginal delivery and probably best option was elective ventouse or forceps. In conclusion despite potential difficulties and complications associated with corrected tetralogy of Fallot, careful cardiac and obstetric management resulted in good maternal and fetal outcomes.