Pregnancy in women with Fontan physiology

Abstract

Advances in the care of patients with a univentricular heart have enabled the majority to survive well into adulthood. Consequently, an increasing number of women with Fontan palliation are contemplating pregnancy. This review summarizes physiologic modifications related to pregnancy in the setting of single-ventricle physiology, discusses potential maternal cardiovascular concerns and describes commonly encountered obstetrical and neonatal complications. Management issues are addressed, including counseling, anesthetic considerations and the need for multidisciplinary specialized care.

Keywords::

• congenital heart disease
• Fontan procedure
• high-risk obstetrics
• pregnancy
• univentricular heart

Financial & competing interests disclosure

P Khairy is supported by a Canada Research Chair in Adult Congenital Heart Disease and Electrophysiology. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.