Pregnancy in patients with the Fontan operation.
Claudia MontanaroSiobhan BoyleGurleen WanderMark R JohnsonJolien W Roos-HesselinkRoshni PatelIsma RafiqCandice K SilversidesMichael A GatzoulisPublished in: European journal of preventive cardiology (2024)
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.
Keyphrases
- preterm birth
- pregnancy outcomes
- healthcare
- body weight
- quality improvement
- palliative care
- public health
- gestational age
- mental health
- randomized controlled trial
- low birth weight
- pregnant women
- pulmonary hypertension
- systematic review
- risk assessment
- climate change
- birth weight
- body mass index
- preterm infants
- skeletal muscle
- atrial fibrillation
- pain management
- smoking cessation
- insulin resistance
- weight gain
- hiv infected
- human health
- glycemic control
- free survival
- meta analyses