Successful Pregnancy after a Heart Transplant in Iran: A Case Report

Fateme Mehri; Kianoush Saberi; Mehrdad Salehi; Fahimeh  Ghotbizadeh Vahdani; Farnoosh Larti; Alireza Bakhshandeh; Shahrzad Sheikhhasani

doi:10.18502/jthc.v18i4.14829

Fateme Mehri Department of Gynecology and Obstetrics, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Kianoush Saberi Department of Anesthesiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mehrdad Salehi Department of Cardiac Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Fahimeh Ghotbizadeh Vahdani Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Farnoosh Larti Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Alireza Bakhshandeh Department of Cardiac Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Shahrzad Sheikhhasani Department of Gynecology and Obstetrics, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jthc.v18i4.14829

Keywords: Heart transplantation; Pregnancy; Delivery; Obstetric; Immunocompromised host

Abstract

Pregnancy after a heart transplant is a concern for many female recipients, and it remains a medical challenge that raises many questions. A 24-year-old woman, gravida 3, para 0, contacted us for obstetric care in the first trimester of gestation, about 3 years after an orthotopic cardiac transplant. She was a known case of dextrocardia with congenitally corrected transposition of the great arteries. The transplant had been performed for severe retractable heart failure, manifesting during her previous lost pregnancy. The course of the current gestation was uneventful. The patient’s cardiovascular function was good throughout the pregnancy. She was admitted to the hospital for dyspnea at 35 weeks and 4 days of gestational age. A cardiovascular consult and echocardiography were performed. The results were within the normal range, and labor pains explained the patient’s dyspnea. Because of labor pain, a repeat Cesarean section was performed at 35 weeks and 4 days of gestational age. A male baby weighing 2700 g, with an Apgar score of 7/9, was delivered. The patient was discharged after delivery with enoxaparin (40 mg), prednisolone (5 mg), levothyroxine, and mycophenolate mofetil (500 mg) without any complications. Follow-up was carried out at 1 month, and no abnormality was found. Here, we report a case of a successful pregnancy in a young woman after a heart transplant.