Now we don’t need to worry about Olivia even thinking about becoming pregnant for many, many years. However, we have been told that single ventricle patients are discouraged from getting pregnant because of the risks associated with their hearts.
I came across this on one of the message boards I post at:
Anaesthesia Volume 60 Issue 11 Page 1137 - November 2005 doi:10.1111/j.1365-2044.2005.04334.x CASE REPORT Caesarean section following the Fontan procedure: two different deliveries and different anaesthetic choices in the same patient L. Eid1, Y. Ginosar2, U. Elchalal3, A. Pollak4 and C. F. Weiniger5 Summary 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.
Here is what I found in the medical literature last time I searched this topic (a few years ago): The largest, most often cited study of pregnancy in Fontans was published in 1996, looking at 33 pregnancies in 21 single ventricle mommies. There were 13 miscarriages, 5 abortions (10 or 15 years ago, these women were often counselled that pregnancy put their own life in danger) and 15 live births, ranging from 28 weeks gestation to full term. No maternal mortality, one complication (arrythmia). The big difference between these patients and our current "crop" of Fontans, is that most of them had their Fontans as teenagers or young adults, so they lived with cyanosis for many years before getting fixed. A more recent article (2001) reports 4 "successful" pregnancies in 3 Fontan patients. The babies were all premature (26-35 weeks), there were some maternal complications (arrhythmia, ventricular dysfunction, and fluid build up) but all were medically managed - no mortality. So, bottom line..... Cautious Optimism! I expect in 20-30 years, Pregnancy in Fontans will be much more common place and not so scary. By then we will figure out how to optimize the outcome for mom and baby.
So with medical advances, Olivia's chances of becoming a mom herself are very good!