Pregnancy in a woman with a Fontan circulation: A review

doi:10.1177/1753495X17737680

Review

. 2018 Mar;11(1):6-11.

doi: 10.1177/1753495X17737680. Epub 2017 Nov 22.

Pregnancy in a woman with a Fontan circulation: A review

Emily Moroney^{1

2}, Elske Posma³, Alicia Dennis^{4

5

6}, Yves d'Udekem^{1

2

7}, Rachael Cordina^{8

9}, Dominica Zentner^{10

11}

Affiliations

¹ Murdoch Children's Research Institute, Melbourne, Australia.
² Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
³ Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Victoria, Australia.
⁴ Department of Anaesthesia, The Royal Women's Hospital, Victoria, Australia.
⁵ Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.
⁶ Department of Pharmacology, The University of Melbourne, Melbourne, Australia.
⁷ 7Department of Cardiac Surgery, Royal Children's Hospital Melbourne, Melbourne, Australia.
⁸ Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁹ Central Clinical School, The University of Sydney, Camperdown, NSW, Australia.
¹⁰ Department of Cardiology, The Royal Melbourne Hospital, Victoria, Australia.
¹¹ Department of Medicine Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.

PMID: 29636807
PMCID: PMC5888845
DOI: 10.1177/1753495X17737680

Review

Pregnancy in a woman with a Fontan circulation: A review

Emily Moroney et al. Obstet Med. 2018 Mar.

. 2018 Mar;11(1):6-11.

doi: 10.1177/1753495X17737680. Epub 2017 Nov 22.

Authors

Emily Moroney^{1

2}, Elske Posma³, Alicia Dennis^{4

5

6}, Yves d'Udekem^{1

2

7}, Rachael Cordina^{8

9}, Dominica Zentner^{10

11}

Affiliations

¹ Murdoch Children's Research Institute, Melbourne, Australia.
² Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
³ Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Victoria, Australia.
⁴ Department of Anaesthesia, The Royal Women's Hospital, Victoria, Australia.
⁵ Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia.
⁶ Department of Pharmacology, The University of Melbourne, Melbourne, Australia.
⁷ 7Department of Cardiac Surgery, Royal Children's Hospital Melbourne, Melbourne, Australia.
⁸ Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁹ Central Clinical School, The University of Sydney, Camperdown, NSW, Australia.
¹⁰ Department of Cardiology, The Royal Melbourne Hospital, Victoria, Australia.
¹¹ Department of Medicine Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.

PMID: 29636807
PMCID: PMC5888845
DOI: 10.1177/1753495X17737680

Abstract

More women with congenital heart disease survive to childbearing ages, due to improvements in surgical practice and postoperative care. This review discusses pregnancy in women with a single ventricle, describing maternal obstetric and cardiovascular complications and the increased risks of prematurity and adverse neonatal outcomes. Recommendations are made based on current understanding, guidelines and published literature, with recognition that there is much knowledge yet to be gained.

Keywords: Fontan circulation; Heart defects; arrhythmias; cardiac; congenital; heart failure; pregnancy complications.

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References

1. Gewillig M, Brown SC. The Fontan circulation after 45 years: update in physiology. Heart 2016; 102: 1081–1086. - PMC - PubMed
1. Clark SL, Cotton DB, Lee W, et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol 1989; 161(6 Pt 1): 1439–1442. - PubMed
1. Robson SC, Hunter S, Boys RJ, et al. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989; 256: H1060–H1065. - PubMed
1. Knight M, Nair M, Tuffnell D, et al. (eds.) on behalf of MBRRACE-UK. Saving lives, improving mothers’ care – surveillance of maternal deaths in the UK 2012–2014 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14. Oxford: University of Oxford, National Perinatal Epidemiology Unit, 2016.
1. Humphrey M. Maternal mortality trends in Australia. The Medical Journal of Australia 2016; 205(8): 344–346. - PubMed

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[1] Gewillig M, Brown SC. The Fontan circulation after 45 years: update in physiology. Heart 2016; 102: 1081–1086. - PMC - PubMed

[2] Gewillig M, Brown SC. The Fontan circulation after 45 years: update in physiology. Heart 2016; 102: 1081–1086. - PMC - PubMed

[3] Clark SL, Cotton DB, Lee W, et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol 1989; 161(6 Pt 1): 1439–1442. - PubMed

[4] Clark SL, Cotton DB, Lee W, et al. Central hemodynamic assessment of normal term pregnancy. Am J Obstet Gynecol 1989; 161(6 Pt 1): 1439–1442. - PubMed

[5] Robson SC, Hunter S, Boys RJ, et al. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989; 256: H1060–H1065. - PubMed

[6] Robson SC, Hunter S, Boys RJ, et al. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol 1989; 256: H1060–H1065. - PubMed

[7] Knight M, Nair M, Tuffnell D, et al. (eds.) on behalf of MBRRACE-UK. Saving lives, improving mothers’ care – surveillance of maternal deaths in the UK 2012–2014 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14. Oxford: University of Oxford, National Perinatal Epidemiology Unit, 2016.

[8] Knight M, Nair M, Tuffnell D, et al. (eds.) on behalf of MBRRACE-UK. Saving lives, improving mothers’ care – surveillance of maternal deaths in the UK 2012–2014 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14. Oxford: University of Oxford, National Perinatal Epidemiology Unit, 2016.

[9] Humphrey M. Maternal mortality trends in Australia. The Medical Journal of Australia 2016; 205(8): 344–346. - PubMed

[10] Humphrey M. Maternal mortality trends in Australia. The Medical Journal of Australia 2016; 205(8): 344–346. - PubMed

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Pregnancy in a woman with a Fontan circulation: A review

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Pregnancy in a woman with a Fontan circulation: A review

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