A case study of Ebstein Anomaly in Pregnancy

Ebstein anomaly is a rare congenital heart defect that affects the tricuspid valve and constitutes about 1% of congenital heart defects, with a prevalence of 5.2 per 100,000 live births. It often coexists with other cardiac (38.3%) and non-cardiac anomalies (19.1%). Diagnosis typically involves imaging methods like echocardiography and cardiac magnetic resonance. Women with Ebstein anomaly generally tolerate pregnancy well, but they may face complications such as arrhythmias, cyanosis, heart failure, and paradoxical cerebral embolism. Thus, it is crucial to closely monitor clinical and haemodynamic changes throughout pregnancy in order to identify risks early and improve delivery techniques.

In this case study, a 26-year-old woman, currently pregnant at 32 weeks and 3 days, presented with generalized edema and high blood pressure. She had a previous spontaneous abortion but no significant history of hypertension or heart disease. Upon examination, she displayed pallor, pedal edema, and elevated blood pressure, with echocardiography confirming Ebstein anomaly and severe tricuspid regurgitation. The patient was diagnosed with preeclampsia, and despite antihypertensive treatment, her blood pressure escalated, leading to the decision for an emergency cesarean section due to fetal distress. A live baby was delivered, and both mother and child had positive outcomes post-surgery.

To conclude, while Ebstein anomaly is rare in pregnancy, effective monitoring and management can lead to successful maternal and neonatal outcomes. Despite the inherent risks, many women with this condition can safely undergo pregnancy, although close observation is necessary, especially in cases with additional complications.

Source: Kaur T, Surabhi P, Mirza MA. Pregnancy with Ebstein anomaly and early onset severe preeclampsia - a rare case. 2024; 10(2): 439 - 41. DOI -10.21276/obgyn.2024.10.2.36.