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Sonographic Evaluation of the Placenta in Fontan Patients: A Case Series
Rachael Putman1, Sarah A Goldstein2, Brita Boyd3
1Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA.
Insights
Individuals with Fontan circulation face higher risks in pregnancy. This case series highlights placental imaging findings and outcomes in these high-risk pregnancies, offering insights for improved maternal and fetal care.
Area of Science:
- Cardiology
- Obstetrics
- Pediatric Surgery
Background:
- Advances in pediatric cardiothoracic surgery have increased the number of adults with congenital heart disease reaching reproductive age.
- Individuals with Fontan circulation have a well-established increased risk of adverse maternal and fetal outcomes during pregnancy.
Abstract:
Due to the advancements in pediatric cardiothoracic surgery and medical management, more individuals with congenital heart disease are reaching reproductive age. It is well established that individuals with Fontan circulation are at an increased risk for maternal and fetal adverse outcomes including maternal cardiovascular complications, hypertensive disorders of pregnancy, preterm birth, and fetal growth restriction. Early onset of poor placental health likely related to chronically elevated central venous pressure/low cardiac output inherited to Fontan circulation may play a role in the development of these outcomes. In this case series, we present second-trimester placental imaging findings and pregnancy outcomes of three individuals with Fontan circulation who delivered at a tertiary center in the Southeastern United States.
