Document Detail

Pregnancy and delivery in women after Fontan palliation.
MedLine Citation:
PMID:  16449503     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To evaluate the outcome of pregnancy in women after Fontan palliation and to assess the occurrence of infertility and menstrual cycle disorders.
DESIGN AND PATIENTS: Two congenital heart disease registries were used to investigate 38 female patients who had undergone Fontan palliation (aged 18-45 years): atriopulmonary anastomosis (n = 23), atrioventricular connection (n = 5) and total cavopulmonary connection (n = 10).
RESULTS: Six women had 10 pregnancies, including five miscarriages (50%) and one aborted ectopic pregnancy. During the remaining four live-birth pregnancies clinically significant complications were encountered: New York Heart Association class deterioration; atrial fibrillation; gestational hypertension; premature rupture of membranes; premature delivery; fetal growth retardation and neonatal death. Four of seven women who had attempted to become pregnant reported female infertility: non-specified secondary infertility (n = 2), uterus bicornis (n = 1) and related to endometriosis (n = 1). Moreover, several important menstrual cycle disorders were documented. In particular, the incidence of primary amenorrhoea was high (n = 15, 40%), which resulted in a significant increase in age at menarche (14.6 (SD 2.1) years, p < 0.0001, compared with the general population).
CONCLUSION: Women can successfully complete pregnancy after adequate Fontan palliation without important long-term sequelae, although it is often complicated by clinically significant (non-)cardiac events. In addition, subfertility or infertility and menstrual disorders were common.
W Drenthen; P G Pieper; J W Roos-Hesselink; W A van Lottum; A A Voors; B J M Mulder; A P J van Dijk; H W Vliegen; K M Sollie; P Moons; T Ebels; D J van Veldhuisen;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-01-31
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  92     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-15     Completed Date:  2006-09-12     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1290-4     Citation Subset:  AIM; IM    
Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
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MeSH Terms
Fontan Procedure*
Heart Defects, Congenital / complications,  surgery*
Infertility, Female / etiology
Menstruation Disturbances / etiology
Middle Aged
Palliative Care*
Pregnancy Complications / etiology*
Pregnancy Complications, Cardiovascular*
Pregnancy Outcome
Comment In:
Heart. 2007 Feb;93(2):152-4   [PMID:  17035511 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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