Twin pregnancy in a Fontan-palliated patient

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.

Twin pregnancy complicated by total placenta previa in a Fontan-palliated patient: A case report

“…Only 4 cases of twin pregnancies in women with a Fontan circulation have been reported. Among the 4 cases, 2 were described in detail as case reports [ 11 , 12 ], and 2 were included in research articles where detailed information on clinical course was lacking [ 1 , 4 ]. In a case reported by Nair et al, the patient had significant deterioration in cardiovascular function at 33 weeks' gestation, necessitating emergency cesarean section [ 11 ].…”

“…Among the 4 cases, 2 were described in detail as case reports [ 11 , 12 ], and 2 were included in research articles where detailed information on clinical course was lacking [ 1 , 4 ]. In a case reported by Nair et al, the patient had significant deterioration in cardiovascular function at 33 weeks' gestation, necessitating emergency cesarean section [ 11 ]. Nir et al reported a case involving a patient who complained of shortness of breath after climbing two flights of stairs (functional class II) at 30 weeks' gestation [ 12 ].…”