Systemic right ventricle after disposition of great vessels is categorized under which WHO group?

Systemic right ventricle after disposition of great vessels is categorized under which WHO group?

• A. Group II
• B. Group III
• C. Group IV
• D. Not categorized

Answer: (B)

In the WHO risk classification for pregnancy with cardiovascular disease, conditions that carry a significantly increased risk of maternal morbidity or mortality are placed in Group III. A systemic right ventricle after disposition of the great vessels represents a high-risk situation because the right ventricle is serving as the systemic pump. Pregnancy brings about substantial hemodynamic changes—plasma volume expansion, increased heart rate, and higher cardiac output—that the systemic right ventricle is not well equipped to handle over time. This can lead to ventricular dysfunction, heart failure, arrhythmias, and other complications for the mother, even with prior corrective surgery such as an atrial switch in transposition of the great arteries. While not an absolute contraindication in all centers, it requires careful high-risk multidisciplinary management, aligning with Group III. It is not Group II (lower risk) or Group IV (pregnancy contraindicated in the most extreme cases).

In the WHO risk classification for pregnancy with cardiovascular disease, conditions that carry a significantly increased risk of maternal morbidity or mortality are placed in Group III. A systemic right ventricle after disposition of the great vessels represents a high-risk situation because the right ventricle is serving as the systemic pump. Pregnancy brings about substantial hemodynamic changes—plasma volume expansion, increased heart rate, and higher cardiac output—that the systemic right ventricle is not well equipped to handle over time. This can lead to ventricular dysfunction, heart failure, arrhythmias, and other complications for the mother, even with prior corrective surgery such as an atrial switch in transposition of the great arteries. While not an absolute contraindication in all centers, it requires careful high-risk multidisciplinary management, aligning with Group III. It is not Group II (lower risk) or Group IV (pregnancy contraindicated in the most extreme cases).