Ebstein Anomaly with Pregnancy: A Rare Case

Background: Ebstein anomaly is an uncommon, complex congenital malformation of the heart with an incident of one in 20000 live births, characterized by the typical displacement of septal and posterior leaflets of the tricuspid valve resulting in reduction in size of the right ventricle and atrialised of upper part of the right ventricle that behaves functionally as a part of the right atrium. These patients have severe tricuspid insufficiency which contributes to the enlargement of the right atria. Maternal mortality due to Ebstein is considered to be less than 1% in asymptomatic patients but may be as high as 5-15%, if aggravated by conditions like supraventricular arrhythmia, WPW syndrome or atrial fibrillation. Case Presentation: A 26-year-old G4P2A1L0 at 33 weeks 2 days gestation with a known with a known case of Ebstein anomaly was referred to Civil Hospital Ahmedabad in August 2020 with complain of breathlessness for further management as our institute is having well equipped cardiac care facilities. She was diagnosed as case of ebstein anomaly during 6-month amenorrhea and it was confirmed by ECHO during her treatment of cervical insufficiency. Antenatal steroid administration was done, and cardiology opinion was taken for termination of pregnancy, elective LSCS was done at 35 weeks and healthy baby weight 2.3 kg was delivered. Intrapartum and postpartum period was uneventfully. Conclusion: Due to varied clinical presentations, ebstein anomaly needed multidisciplinary approach during antenatal period to be diagnosed in term of any complications and treated accordingly.