Key result
A parturient with Fontan physiology successfully underwent two consecutive caesarean deliveries (one under general and one under regional anaesthesia) without adverse effects on maternal cardiac status.
Case Report (n=1)
Caesarean delivery can be safely performed under both general and regional anaesthesia in patients with Fontan physiology, though fetal risks require attention.
Supports anaesthetic options for caesarean in Fontan parturients; hypothesis-generating and should not yet change practice.
The Fontan procedure is performed for patients with a hypoplastic right ventricle, and pregnancies following this palliative surgery are likely to increase. We present a parturient with the Fontan physiology who successfully underwent two consecutive caesarean deliveries; the first under general anaesthesia for emergency surgery and the second under regional anaesthesia for elective surgery. We suggest that pregnancy and delivery do not typically adversely affect maternal cardiac status in these patients. Attention must be paid, however, to fetal loss, prematurity, growth retardation and associated cardiac congenital malformations for which insufficient data exist in the literature in this patient population.
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Eid et al. (2005) conducted a case report in Fontan physiology in pregnancy (n=1). Caesarean delivery under general and regional anaesthesia was evaluated. A parturient with Fontan physiology successfully underwent two consecutive caesarean deliveries (one under general and one under regional anaesthesia) without adverse effects on maternal cardiac status.
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