A case of placental insufficiency and premature delivery in a Fontan pregnancy: physiological insights and considerations on risk stratification

Maria Victoria Ordonez *, Giovanni Biglino, Massimo Caputo, Brenda Kelly, Aarthi R. Mohan, Johanna Trinder, Stephanie L Curtis

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

Abstract

Objectives: The coexistence of two complex physiologies such as Fontan and pregnancy is still not fully understood. We aim to add a unique and essential knowledge to help our colleagues in the management of Fontan patients that undergo pregnancy as well as the foetus and the placenta perfusion.

Methods and Results: We analyse the coexistence of Fontan and pregnancy physiology on a complex case of a woman with hypoplastic left heart syndrome (HLHS) palliated with a univentricular repair who became pregnant, delivered very prematurely and had atypical placental findings.

Conclusion: Histopathological analysis of the placenta could help us to refine the understanding of Fontan physiology adaptation during pregnancy, predict women and foetal outcomes as well as to plan a better pre-pregnancy status. However, further evidence is needed in order to reach a more solid and unify conclusion.
Original languageEnglish
JournalOpen Heart
Publication statusAccepted/In press - 2 Oct 2020

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