Cardiovascular, obstetric and neonatal outcomes in women with previous fontan repair

S J Bonner, O Asghar, A Roberts, S Vause, B Clarke, B Keavney

Research output: Contribution to journalReview articlepeer-review


OBJECTIVES: To determine cardiovascular, obstetric and neonatal outcomes of pregnancies in women who have a Fontan circulation.

METHODS: A retrospective case note review of all women with a Fontan circulation who attended the joint obstetric cardiac antenatal clinic at St Mary's Hospital, Manchester (UK) between 2004 and 2016 was performed.

RESULTS: In total, there were 19 pregnancies in 9 women with a history of Fontan repair. 23 women with univentricular physiology attended in this time period. 10 pregnancies (53%) resulted in live births; 1 in a stillbirth at 31 weeks gestation and 8 in miscarriage. Cardiovascular complications occurred in 2 pregnancies (11%). There were no thrombotic events, arrhythmias, myocardial infarction, or endocarditis in the antenatal or postnatal period. Obstetric complications included miscarriage (26% first trimester, 16% second trimester), along with premature delivery (24-36+6) (80%) and fetal growth restriction (70%). The majority of women were delivered by caesarean section (60%).

CONCLUSIONS: Women who become pregnant following a Fontan repair carry an increased risk of cardiovascular complications. Fetal and neonatal complication rates are high and emphasize the importance of thorough, multidisciplinary, pre-conceptual assessment and counseling to allow patients to make informed decisions regarding future pregnancy.

Original languageEnglish
Pages (from-to)53-56
Number of pages4
JournalEuropean journal of obstetrics, gynecology, and reproductive biology
Early online date16 Oct 2017
Publication statusPublished - Dec 2017


  • Adult
  • Female
  • Fontan Procedure
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Pregnancy
  • Pregnancy Complications, Cardiovascular/epidemiology
  • Pregnancy Outcome
  • Retrospective Studies
  • Tertiary Care Centers/statistics & numerical data
  • United Kingdom/epidemiology
  • Young Adult


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