Successful pregnancy in a patient with univentricular heart and pulmonary stenosis

Abstract

Univentricular heart or single ventricle heart is a rare and complex congenital heart disease (CHD). We report the successful management of a parturient with a single ventricle, and pulmonary stenosis. The univentricular heart is discussed in detail and the maternal and fetal outcome in pregnant women with CHD is reviewed.

Two successful pregnancies in a patient with Fontan-repaired dextrocardiac univentricular heart

“…Pulmonary stenosis or atresia is commonly associated with univentricular hearts. 1,3 The Fontan procedure is a palliative staged operation for all children who cannot undergo two ventricular repair. The BDGS surgery is usually performed at the age between 2-6 months followed by Fontan correction at 2-3 years of age when the child is ambulatory.…”

“…Vaginal delivery is recommended in pregnant women with functionally normal univentricular hearts unless an obstetric indication for caesarian section. 3 During 48-72 hours after delivery, there is an increased risk of cardiac failure and pulmonary oedema due to autotransfusion phenomenon and therefore a need for close monitoring during this period. Repeat echocardiography between 6-8 weeks after the delivery is preferred to identify any delayed complications.…”

“…5 In addition, they are at increased risk of maternal complications such as maternal heart failure, pregnancy-induced hypertension, pulmonary oedema, infective endocarditis, haemorrhage, thrombosis, and maternal death. 3 It is recommended that Fontan patients should have at least monthly monitoring during the pregnancy and the first week after the delivery. They should be managed at a tertiary care center by a multidisciplinary team, that consists of an obstetrician, cardiologist, haematologist anesthetist, and neonatalogist.…”