Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-05-05T08:48:45.594Z Has data issue: false hasContentIssue false

Twin pregnancy in a Fontan-palliated patient

Published online by Cambridge University Press:  29 April 2016

Anupama Nair*
Affiliation:
Department of Pediatric Cardiology, FORTIS-ESCORT Heart Institute, New Delhi, India
Sitaraman Radhakrishnan
Affiliation:
Department of Pediatric Cardiology, FORTIS-ESCORT Heart Institute, New Delhi, India
Krishna S. Iyer
Affiliation:
Department of Pediatric Cardiology, FORTIS-ESCORT Heart Institute, New Delhi, India
*
Correspondence to: A. Nair, Department of Pediatric Cardiology, FORTIS-ESCORT Heart Institute, 5th floor, Okhla Road, New Delhi 110025, India. Tel: +91-9818811317; E-mail: dranu80nair@gmail.com

Abstract

The Fontan connection, originally described in 1971, is used to provide palliation for patients with many forms of CHDs that cannot support a biventricular circulation. An increasing number of females who have undergone these connections in childhood are now surviving into adulthood and some are becoming pregnant. We report a case of a 29-year-old woman who presented with a twin pregnancy at 33 weeks of gestation. She had significant deterioration of her cardiovascular status before the twin babies were delivered by emergency caesarean section owing to associated obstetric complications. This report also highlights the various maternal and fetal complications occurring in pregnancy of Fontan-palliated patients and suggests the need for meticulous pre-conception counselling and strict perinatal care.

Type
Brief Reports
Copyright
© Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kuleva, M, Youssef, A, Maroni, E, et al. Maternal cardiac function in normal twin pregnancy: a longitudinal study. Ultrasound Obstet Gynecol 2011; 38: 575580.Google Scholar
2. Inoue, S, Masuyama, H, Akagi, T, Hiramatsu, Y. Pregnancy and delivery in patients with Fontan circulation: a report of two cases. J Obstet Gynaecol Res 2013; 39: 378382.Google Scholar
3. Canobbio, MM, Cetta, F, Silversides, C, Warnes, C, Aboulhosn, J, Colman, J. Pregnancy after Fontan operation: early and late outcomes. J Am Coll Cardiol 2013; 61: doi:10.1016/S0735-1097(13)60427-1.Google Scholar
4. Lee, JR, Kwak, JG, Kim, KC, et al. Comparison of lateral tunnel and extracardiac conduit Fontan procedure. Interact Cardiovasc Thorac Surg 2007; 6: 328330.CrossRefGoogle ScholarPubMed
5. Parry, S, Strauss, JF III. Premature rupture of the fetal membranes. N Engl J Med 1998; 338: 663670.Google Scholar
6. Bdolah, Y, Lam, C, Rajakumar, A, et al. Twin pregnancy and the risk of preeclampsia: bigger placenta or relative ischemia? Am J Obstet Gynecol. 2008; 198: 428.e1428.e6.Google Scholar
7. Melchiorre, K, Sharma, R, Thilaganathan, B. Cardiovascular implications in preeclampsia: an overview. Circulation 2014; 130: 703714.Google Scholar
8. Drenthen, W, Pieper, PG, Roos-Hessenlink, JW, et al. Pregnancy and delivery on women after Fontan palliation. Heart 2006; 92: 12901294.Google Scholar
9. McRae, ME. Long-term issues after the Fontan procedure. AACN Adv Crit Care 2013; 24: 264282.Google Scholar
10. Gouton, M, Nizard, J, Patel, M, et al. Maternal and fetal outcomes of pregnancy with Fontan circulation: a multicentric observational study. Int J Cardiol 2015; 187: 8489.Google Scholar