Twin pregnancy complicated by total placenta previa in a Fontan-palliated patient: A case report

Aoi Morita, Saki Kido, Masahiro Hachisuga, Hazumu Nagata, Nobuhiro Hidaka, Kiyoko Kato

Research output: Contribution to journalArticle

Abstract

We present a case of a twin pregnancy in a Fontan-palliated woman that was complicated by total placenta previa. The patient was diagnosed with tricuspid atresia type II, and underwent the Fontan operation at 11 years of age. At 32 years of age, she was shown to have a dichorionic diamniotic twin pregnancy. A placenta previa was also noted. At 26 weeks’ gestation, she had difficulty breathing, cardiomegaly, and worsening mitral regurgitation. At 29 weeks’ gestation, an emergency cesarean section was performed, as the patient had massive genital bleeding. A postoperative cardiac catheterization demonstrated a leak from the lateral tunnel to the atrium, which was considered a cause of hypoxemia during the peripartum period. The cardiac workload in a twin pregnancy is greater, which places a Fontan-palliated patient at increased risk. Careful follow-up monitoring with multidisciplinary expertise is recommended.

Original languageEnglish
Article numbere00085
JournalCase Reports in Women's Health
Volume20
DOIs
Publication statusPublished - Oct 1 2018

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Placenta Previa
Twin Pregnancy
Tricuspid Atresia
Fontan Procedure
Peripartum Period
Pregnancy
Cardiomegaly
Mitral Valve Insufficiency
Cardiac Catheterization
Workload
Cesarean Section
Respiration
Emergencies
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

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title = "Twin pregnancy complicated by total placenta previa in a Fontan-palliated patient: A case report",
abstract = "We present a case of a twin pregnancy in a Fontan-palliated woman that was complicated by total placenta previa. The patient was diagnosed with tricuspid atresia type II, and underwent the Fontan operation at 11 years of age. At 32 years of age, she was shown to have a dichorionic diamniotic twin pregnancy. A placenta previa was also noted. At 26 weeks’ gestation, she had difficulty breathing, cardiomegaly, and worsening mitral regurgitation. At 29 weeks’ gestation, an emergency cesarean section was performed, as the patient had massive genital bleeding. A postoperative cardiac catheterization demonstrated a leak from the lateral tunnel to the atrium, which was considered a cause of hypoxemia during the peripartum period. The cardiac workload in a twin pregnancy is greater, which places a Fontan-palliated patient at increased risk. Careful follow-up monitoring with multidisciplinary expertise is recommended.",
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AU - Kido, Saki

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AU - Hidaka, Nobuhiro

AU - Kato, Kiyoko

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N2 - We present a case of a twin pregnancy in a Fontan-palliated woman that was complicated by total placenta previa. The patient was diagnosed with tricuspid atresia type II, and underwent the Fontan operation at 11 years of age. At 32 years of age, she was shown to have a dichorionic diamniotic twin pregnancy. A placenta previa was also noted. At 26 weeks’ gestation, she had difficulty breathing, cardiomegaly, and worsening mitral regurgitation. At 29 weeks’ gestation, an emergency cesarean section was performed, as the patient had massive genital bleeding. A postoperative cardiac catheterization demonstrated a leak from the lateral tunnel to the atrium, which was considered a cause of hypoxemia during the peripartum period. The cardiac workload in a twin pregnancy is greater, which places a Fontan-palliated patient at increased risk. Careful follow-up monitoring with multidisciplinary expertise is recommended.

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