Management of Fontan circulation in pregnancy: a multidisciplinary approach to care
| Autor: | Kathryn J. Lindley, Michael Dombrowski, Amber C. Benhardt, Jeannie Kelly, Molly J. Stout, Bethany A. Sabol, Jaquelyn Fleckenstein, Natasha K. Wolfe |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Heart Defects
Congenital Pulmonary Circulation congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Heart disease Population Decreased cardiac output Fontan Procedure Univentricular Heart Pregnancy Multidisciplinary approach medicine Humans Child Intensive care medicine education education.field_of_study Fetus business.industry Postpartum Period General Medicine Venous blood medicine.disease medicine.anatomical_structure Ventricle Female business |
| Zdroj: | American Journal of Obstetrics & Gynecology MFM. 3:100257 |
| ISSN: | 2589-9333 |
| DOI: | 10.1016/j.ajogmf.2020.100257 |
| Popis: | The Fontan operation was first performed in 1968 and is a palliative procedure for children born with single ventricle forms of congenital heart disease. Today, 70,000 patients worldwide have Fontan circulation today, half of them women, and with an expected 30-year survival of >80%, this population is expected to double in the next 20 years. The Fontan operation surgically redirects systemic venous blood return directly to the pulmonary circulation, bypassing the single ventricle. This abnormal anatomy results in significant challenges for the cardiovascular system and is marked by a sustained, abnormally elevated systemic venous pressure combined with decreased cardiac output. As more women with Fontan circulation reach childbearing age, understanding the unique risks of pregnancy to the mother and fetus and how to best provide clinical care for these women during pregnancy is imperative. However, there are limited clinical data to guide counseling and management in this population. This expert review offers an analysis of the literature about Fontan circulation during pregnancy and describes our center's current multidisciplinary approach to care for these women in the preconception, antepartum, intrapartum, and postpartum periods. |
| Databáze: | OpenAIRE |
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