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Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring
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Management of Fontan circulation in pregnancy: a multidisciplinary approach to care

Natasha K Wolfe1, Bethany A Sabol2, Jeannie C Kelly2

  • 1Cardiovascular Division, Department of Internal Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO.

American Journal of Obstetrics & Gynecology MFM
|January 16, 2021
PubMed

Insights

Women with Fontan circulation face unique pregnancy risks. This review analyzes current literature and outlines a multidisciplinary approach for optimal preconception, pregnancy, and postpartum care for these patients.

Area of Science:

  • Cardiology
  • Reproductive Medicine
  • Pediatric Surgery

Background:

  • The Fontan operation, a palliative surgery for single ventricle congenital heart disease, impacts cardiovascular physiology.
  • Over 70,000 individuals worldwide have Fontan circulation, with a growing population of women reaching childbearing age.
  • Increased Fontan population survival necessitates understanding pregnancy-related risks and management.

Purpose of the Study:

  • To review existing literature on pregnancy in women with Fontan circulation.
  • To describe a multidisciplinary approach for managing these pregnancies.
  • To guide clinical care from preconception through postpartum.

Main Methods:

  • Expert review of current literature on Fontan circulation and pregnancy.
  • Analysis of cardiovascular challenges in Fontan patients during gestation.
  • Description of a center's integrated care model.

Main Results:

  • Limited clinical data currently exists for guiding pregnancy management in this population.
  • Fontan circulation presents unique maternal and fetal risks due to altered hemodynamics.
  • A structured, multidisciplinary approach is essential for optimizing outcomes.

Conclusions:

  • Pregnancy in women with Fontan circulation requires specialized, comprehensive care.
  • Further research is needed to establish evidence-based guidelines.
  • Optimizing preconception, antepartum, intrapartum, and postpartum care is critical for maternal and fetal well-being.

Keywords:
Fontan circulationadult congenital heart diseasecardio-obstetricshigh-risk pregnancymultidisciplinarysingle ventricle physiology

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