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Issues for the mother
Which forms of birth control are safe?
For most women with repaired tetralogy of Fallot, the choice of birth control (medical term: contraceptives) is not limited by cardiac disease. However, in women with unrepaired tetralogy of Fallot, estrogen-containing contraceptives (standard birth control pills) should not be used because of the risk of developing blood clots. Contraceptive selection should be discussed with a physician who has an understanding of your underlying heart condition. (see Birth Control)
What are my risks if I become pregnant?
In order to determine your risk during pregnancy, you should see your heart specialist before getting pregnant. You may be required to have additional heart tests such as an echocardiogram or a magnetic resonance imaging scan (MRI scan) to better determine the risks of pregnancy.
Most women with repaired tetralogy of Fallot tolerate pregnancy well. There is a small risk of heart related complications, such as abnormal fast heart rates (medical term: arrhythmias) or weakening of the heart muscle (medical term: congestive heart failure). If complications occur, they can usually be treated with medications.
Women with unrepaired tetralogy of Fallot are at high risk for complications such as arrhythmias or heart failure. They are also at risk for miscarriages. Whenever possible, surgical correction should be performed prior to pregnancy.
If you had heart failure or a rhythm disturbance before pregnancy, your risk for complications during pregnancy is higher. Other cardiac characteristics can have an impact on pregnancy outcomes (see General Considerations). It is very important to see a congenital heart specialist before pregnancy to discuss your risk of pregnancy.
Some medications are not safe in pregnancy. Do not stop medications without first checking with your doctor, but do check your medications out before pregnancy so you will have a plan. If you did not do that, then do so as soon as you know you are pregnant. The MOTHERISK website is an excellent resource.
