Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Aug 22;31(11):1336-1344.
doi: 10.1093/eurjpc/zwae157.

Pregnancy in patients with the Fontan operation

Claudia Montanaro  1   2 , Siobhan Boyle  1   3 , Gurleen Wander  4 , Mark R Johnson  2   4 , Jolien W Roos-Hesselink  5 , Roshni Patel  2   4 , Isma Rafiq  1 , Candice K Silversides  6 , Michael A Gatzoulis  1   2
Affiliations
Review

Pregnancy in patients with the Fontan operation

Claudia Montanaro et al. Eur J Prev Cardiol. .

Abstract

Improved survival rates for patients with a Fontan circulation has allowed more women with this complex cardiac physiology to contemplate pregnancy. However, pregnancy in women with a Fontan circulation is associated with a high risk of adverse maternal and foetal outcomes, high rates of miscarriage, and preterm delivery. Factors associated with a successful pregnancy outcome are younger age, normal body weight, absence of significant functional limitation, no Fontan-related complications, and well-functioning single ventricle physiology. Appropriate care with timely preconception counselling and regular, frequent clinical reviews by a multidisciplinary team based at a tertiary centre improves the chance of a successful pregnancy. Empowerment of patients with education on their specific congenital cardiac condition and its projected trajectory helps them make informed choices regarding their health, reproductive choices, and assists them to achieve their life goals.

Keywords: Complex Congenital Heart Disease; Fetal complications; Fontan; Fontan operation; Maternal complications; Pregnancy.

Plain language summary

Pregnancy in women with Fontan is feasible but associated with a high risk of adverse maternal/foetal outcomes. Younger age, normal body weight, absence of significant functional limitation, and no Fontan-related complications are favourable factors. Timely preconception counselling and regular clinical reviews in a tertiary centre with an MDT improves pregnancy outcomes. Empowerment of patients with education helps them make informed choices on health, family planning, and the future.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: none declared.

Comment in