Journal article

Bleeding and thrombotic risk in pregnant women with Fontan physiology

Andrea Girnius, Dominica Zentner, Anne Marie Valente, Petronella G Pieper, Katherine E Economy, Magalie Ladouceur, Jolien W Roos-Hesselink, Carri Warshak, Sara L Partington, Zhiqian Gao, Nicholas Ollberding, Michelle Faust, Saulius Girnius, Harald Kaemmerer, Nicole Nagdyman, Scott Cohen, Mary Canobbio, Teiji Akagi, Jasmine Grewal, Elisa Bradley Show all

HEART | BMJ PUBLISHING GROUP | Published : 2021

Abstract

BACKGROUND/OBJECTIVES: Pregnancy may potentiate the inherent hypercoagulability of the Fontan circulation, thereby amplifying adverse events. This study sought to evaluate thrombosis and bleeding risk in pregnant women with a Fontan. METHODS: We performed a retrospective observational cohort study across 13 international centres and recorded data on thrombotic and bleeding events, antithrombotic therapies and pre-pregnancy thrombotic risk factors. RESULTS: We analysed 84 women with Fontan physiology undergoing 108 pregnancies, average gestation 33±5 weeks. The most common antithrombotic therapy in pregnancy was aspirin (ASA, 47 pregnancies (43.5%)). Heparin (unfractionated (UFH) or low molec..

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Grants


Funding Acknowledgements

Sheila Drakeley (Boston Children's Hospital), and the International Society of Adult Congenital Heart Disease (ISACHD, www.isachd.org) and the AARCC under whose auspices this study was supported. EO currently holds the Bitove Family Professorship of Adult Congenital Heart Disease. Dr Elisa Bradley holds a grant with the following grant number:K08HL148701