Pregnancy Outcomes in Women With Fontan Circulation: Single Tertiary Center Experience

Area of Science:

• Cardiology
• Reproductive Medicine
• Pediatric Cardiology

Background:

• The Fontan operation is a palliative treatment for single ventricular physiology.
• Pregnancy in women with Fontan circulation poses significant maternal and fetal risks.
• Limited data exists on maternal and fetal outcomes in this population.

Purpose of the Study:

• To report maternal and fetal outcomes of pregnancies in women with Fontan circulation.
• To assess the feasibility and safety of pregnancy in women with Fontan physiology.

Main Methods:

• Retrospective study of pregnant patients with Fontan physiology from 1986 to 2023.
• Inclusion of miscarriages, premature births, and full-term deliveries.
• Maternal and fetal outcomes were reviewed, including monitoring and management strategies.

Main Results:

• Fifteen pregnancies occurred in eight women, with a 46.7% live birth rate (7 live births, 8 miscarriages).
• Mean gestational age was 36 weeks; 28.6% of live births were premature.
• Two patients experienced postpartum cardiac complications (heart failure, thromboembolism), which were managed successfully.

Conclusions:

• Pregnancy in women with Fontan circulation yielded a 46.7% live birth rate.
• No severe maternal morbidity or mortality was observed despite some cardiac complications.
• Selected women with Fontan circulation can undergo pregnancy and planned delivery with close monitoring.