Bonner SJ, et al. - The cardiovascular, obstetric and neonatal outcomes of pregnancies in women who have a Fontan circulation are ascertained in this study. Based on these outcomes, women who become pregnant following a Fontan repair carry an increased risk of cardiovascular complications. Fetal and neonatal complication rates are high and emphasize the significance of thorough, multidisciplinary, pre-conceptual assessment and counseling to allow patients to make informed decisions in regards to future pregnancy.

Methods

• In this study, they performed retrospective case note review of all women with a Fontan circulation who attended the joint obstetric cardiac antenatal clinic at St Mary’s Hospital, Manchester (UK) between 2004 and 2016.

Results

• They observed 19 pregnancies in 9 women with a history of Fontan repair.
• 23 women with univentricular physiology attended in this time period.
• 10 pregnancies (53%) resulted in live births; 1 in a stillbirth at 31 weeks gestation and 8 in miscarriage.
• They found cardiovascular complications in 2 pregnancies (11%).
• No thrombotic events, arrhythmias, myocardial infarction, or endocarditis were seen in the antenatal or postnatal period.
• Obstetric complications included miscarriage (26% first trimester, 16% second trimester), along with premature delivery (24–36+6) (80%) and fetal growth restriction (70%).
• The greater part of women (60%) were delivered by caesarean section.