---
title: "Maternal and Neonatal Outcomes in Probable Eisenmenger Physiology with Suspected DORV: Case Report"
id: "pubmed-42763816"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42763816"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42763816/"
doi: "10.1186/s43044-026-00781-0"
published_at: "2026-09-20T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Maternal and Neonatal Outcomes in Probable Eisenmenger Physiology with Suspected DORV: Case Report
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42763816
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42763816/)
- **DOI:** [10.1186/s43044-026-00781-0](https://doi.org/10.1186%2Fs43044-026-00781-0)
- **Published At:** 2026-09-20T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Pregnancy with **Eisenmenger syndrome** carries very high maternal and fetal risk; published evidence on pregnancy with uncorrected **double-outlet right ventricle (DORV)** plus Eisenmenger physiology is limited. - A 25-year-old primigravida at 34 weeks presented with progressive dyspnoea, generalized oedema, tachycardia (HR 130/min), tachypnea (RR 25/min) and severe hypoxaemia (SpO2 80% on face-mask oxygen). - Transthoracic echocardiography showed large ventricular and atrial septal defects with flow on colour Doppler, severe tricuspid regurgitation, and an estimated systolic pulmonary artery pressure of 85 mmHg, supporting probable **Eisenmenger physiology**; shunt direction and pulmonary vascular resistance were not documented. - The aorta appeared to arise predominantly from the right ventricle on echo, supporting a suspected **DORV**, but detailed anatomic subtype and great-artery relationships were not defined due to limited imaging. - After multidisciplinary obstetric and cardiology assessment, labour was induced and a vaginal delivery occurred four hours later. - The neonate weighed 2.7 kg with an initial Apgar score of 5 and was admitted to neonatal intensive care for stabilization and monitoring. - Postpartum maternal haemoglobin dropped to 7 g/dL; two units of packed red blood cells were transfused. - The mother required intensive care monitoring for three days, transferred to cardiology on day 6, and was discharged in stable condition on day 7. - The report documents maternal survival through delivery and the first postpartum week with a live birth despite late recognition of probable Eisenmenger physiology and suspected complex congenital heart disease. - The authors emphasize that this single case does not establish the safety of **vaginal delivery** in Eisenmenger syndrome; important haemodynamic, anatomic, anaesthetic, and neonatal details were incomplete and limit causal inference.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Emergency Medicine, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia. drmohamuqtar@gmail.com. * 2 Faculty of Medicine and Health Sciences, Hormuud University, Mogadishu, Somalia. drmohamuqtar@gmail.com. * 3 Department of Emergency Medicine, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey. drmehmetns@gmail.com. * 4 Department of Obstetrics and Gynecology, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia. * 5 Department of Cardiology, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia. * 6 Faculty of Medicine and Health Sciences, Hormuud University, Mogadishu, Somalia. * 7 Department of Emergency Medicine, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey. * 8 Department of Thoracic Surgery, Mogadishu Somalia Turkiye Training and Research Hospital, Mogadishu, Somalia. * PMID: **42763816** * DOI: [ 10.1186/s43044-026-00781-0 ](https://doi.org/10.1186/s43044-026-00781-0) Item in Clipboard # Favorable maternal and neonatal outcomes in probable Eisenmenger physiology with suspected DORV: a case report and literature review Mohamed Mukhtar Mohamed et al. Egypt Heart J. 2026. Show details Display options Display options Format Abstract PubMed PMID Egypt Heart J Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Egypt+Heart+J%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Egypt+Heart+J%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42763816/) . 2026 Sep 20;78(1):70. doi: 10.1186/s43044-026-00781-0. ### Authors [Mohamed Mukhtar Mohamed](https://pubmed.ncbi.nlm.nih.gov/?term=Mohamed+MM&cauthor_id=42763816)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-1 "Department of Emergency Medicine, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia. drmohamuqtar@gmail.com.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-2 "Faculty of Medicine and Health Sciences, Hormuud University, Mogadishu, Somalia. drmohamuqtar@gmail.com."), [Mehmet Necmeddin Sutaşır](https://pubmed.ncbi.nlm.nih.gov/?term=Suta%C5%9F%C4%B1r+MN&cauthor_id=42763816)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-3 "Department of Emergency Medicine, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey. drmehmetns@gmail.com."), [Khadija Yusuf Ali](https://pubmed.ncbi.nlm.nih.gov/?term=Ali+KY&cauthor_id=42763816)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-4 "Department of Obstetrics and Gynecology, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia."), [Osman Farah Dahir](https://pubmed.ncbi.nlm.nih.gov/?term=Dahir+OF&cauthor_id=42763816)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-5 "Department of Cardiology, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia."), [Nurto Abdulkadir Said](https://pubmed.ncbi.nlm.nih.gov/?term=Said+NA&cauthor_id=42763816)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-6 "Faculty of Medicine and Health Sciences, Hormuud University, Mogadishu, Somalia."), [Tuba Doğan](https://pubmed.ncbi.nlm.nih.gov/?term=Do%C4%9Fan+T&cauthor_id=42763816)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-7 "Department of Emergency Medicine, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey."), [Sharmarke Hassan Ali](https://pubmed.ncbi.nlm.nih.gov/?term=Ali+SH&cauthor_id=42763816)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-8 "Department of Thoracic Surgery, Mogadishu Somalia Turkiye Training and Research Hospital, Mogadishu, Somalia."), [Nihat Müjdat Hökenek](https://pubmed.ncbi.nlm.nih.gov/?term=H%C3%B6kenek+NM&cauthor_id=42763816)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42763816/#short-view-affiliation-7 "Department of Emergency Medicine, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey.") ### Affiliations * 1 Department of Emergency Medicine, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia. drmohamuqtar@gmail.com. * 2 Faculty of Medicine and Health Sciences, Hormuud University, Mogadishu, Somalia. drmohamuqtar@gmail.com. * 3 Department of Emergency Medicine, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey. drmehmetns@gmail.com. * 4 Department of Obstetrics and Gynecology, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia. * 5 Department of Cardiology, Mogadishu Somali Turkiye Training and Research Hospital, Mogadishu, Somalia. * 6 Faculty of Medicine and Health Sciences, Hormuud University, Mogadishu, Somalia. * 7 Department of Emergency Medicine, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey. * 8 Department of Thoracic Surgery, Mogadishu Somalia Turkiye Training and Research Hospital, Mogadishu, Somalia. * PMID: **42763816** * DOI: [ 10.1186/s43044-026-00781-0 ](https://doi.org/10.1186/s43044-026-00781-0) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** Pregnancy in Eisenmenger syndrome is associated with very high maternal and fetal risk. Complex congenital anatomy further complicates diagnosis and peripartum management, particularly where advanced imaging and pulmonary hypertension therapies are limited. Published evidence specifically addressing pregnancy with uncorrected DORV and Eisenmenger physiology remains sparse. **Case presentation:** A 25-year-old primigravida at 34 weeks' gestation presented with progressive dyspnoea and generalized oedema. The available record documented a heart rate of 130 beats/min, respiratory rate of 25 breaths/min, oxygen saturation of 80% despite face-mask oxygen, a loud second heart sound, and a systolic murmur. Echocardiography showed large ventricular and atrial septal defects with colour Doppler flow, severe tricuspid regurgitation, and an estimated systolic pulmonary artery pressure of 85 mmHg. In the setting of marked hypoxaemia, these findings supported probable Eisenmenger physiology, although shunt direction and pulmonary vascular resistance were not documented. The aorta appeared to arise predominantly from the right ventricle, supporting suspected DORV, but the origin of both great arteries, VSD-great-artery relationship, and DORV subtype could not be defined. Following cardiology and obstetric assessment, labour was induced and vaginal delivery occurred four hours later. The liveborn neonate weighed 2.7 kg, had an initial Apgar score of 5, and was admitted to neonatal intensive care for stabilisation and monitoring. Postpartum haemoglobin fell to 7 g/dL and two units of packed red cells were transfused. The mother was monitored in intensive care for three days, transferred to cardiology on day 6, and discharged in stable condition on day 7. **Conclusion:** This report documents maternal survival through induced vaginal delivery and the first postpartum week, with a live birth, despite late recognition of probable Eisenmenger physiology and suspected complex congenital heart disease. The report does not establish the safety of vaginal delivery in Eisenmenger syndrome, and incomplete haemodynamic, anatomical, anaesthetic, and neonatal data limit causal interpretation. **Keywords:** Case report; Literature review; Maternal outcome; Neonatal outcome; Probable Eisenmenger physiology; Pulmonary hypertension; Resource-limited setting; Suspected double-outlet right ventricle; Vaginal delivery. © 2026. The Author(s). [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and its later amendments. The Institutional Review Board of Mogadishu Somali-Türkiye Recep Tayyip Erdoğan Training and Research Hospital determined that ethical approval was not required for this single case report. Written informed consent for publication of the clinical details and accompanying images was obtained from the patient. Competing interests: The authors declare no competing interests. ## References 1. 1. Arvanitaki A, Gatzoulis MA, Opotowsky AR et al (2022) Eisenmenger syndrome: JACC state-of-the-art review. J Am Coll Cardiol 79(12):1183–1198. - [DOI](https://doi.org/10.1016/j.jacc.2022.01.022) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/35331414/) 2. 1. Lopez BM, Malhamé I, Davies LK, Gonzalez Velez JM, Marelli A, Rabai F (2020) Eisenmenger syndrome in pregnancy: a management conundrum. J Cardiothorac Vasc Anesth 34(10):2813–2822. - [DOI](https://doi.org/10.1053/j.jvca.2020.02.053) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/32381307/) 3. 1. Yuan SM (2016) Eisenmenger syndrome in pregnancy. Braz J Cardiovasc Surg 31(4):325–329. - [DOI](https://doi.org/10.5935/1678-9741.20160062) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/27849306/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/5094422/) 4. 1. Walters HL 3rd, Mavroudis C, Tchervenkov CI, Jacobs JP, Lacour-Gayet F, Jacobs ML (2000) Congenital Heart Surgery Nomenclature and Database Project: double outlet right ventricle. Ann Thorac Surg 69(4 Suppl):S249–S263. - [DOI](https://doi.org/10.1016/s0003-4975\(99\)01247-3) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/10798433/) 5. 1. Pang KJ, Meng H, Hu SS et al (2017) Echocardiographic classification and surgical approaches to double-outlet right ventricle for great arteries arising almost exclusively from the right ventricle. Tex Heart Inst J 44(4):245–251. - [DOI](https://doi.org/10.14503/thij-16-5759) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/28878577/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/5577949/) Show all 23 references [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42763816/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42763816%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42763816/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42763816%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42763816%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42763816/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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