{
    "abstract": "Given the advances in medicine, women with Fontan circulation are now reaching childbearing age. However, data on the mode of delivery and anesthetic management of these patients are limited. We report the cases of five pregnant women with Fontan circulation.\nThe mean age at delivery was 28\u2009\u00b1\u20093\u00a0years, and the mean gestational period was 34\u00a0weeks and 3\u00a0days. Anticoagulation therapy was switched from warfarin and aspirin to continuous intravenous heparin. The modes of delivery were scheduled cesarean section (C/S) in one, emergency C/S in three, and vaginal delivery with epidural labor analgesia in one patient. Three patients underwent C/S under regional anesthesia; one received general anesthesia. The perinatal complications were heart failure, worsening valve regurgitation, and postoperative hematoma in three, four, and two patients, respectively.\nFor C/S in women with Fontan circulation, regional anesthesia should be considered. Epidural labor analgesia can help prevent the decrease in pulmonary blood flow due to straining. We initiated labor analgesia or C/S with regional anesthesia at the appropriate time in four patients.",
    "authors": [
        {
            "affiliation": "Operating Rooms, Kyushu University Hospital, Fukuoka, Japan. ai-fuji823@hotmail.co.jp.\nDepartment of Anesthesiology, Fukuoka Children's Hospital, Kashiiteriha 5-1-1, Higashi-ku, Fukuoka, 813-0017, Japan. ai-fuji823@hotmail.co.jp.",
            "firstname": "Ai",
            "initials": "A",
            "lastname": "Fujita"
        },
        {
            "affiliation": "Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.",
            "firstname": "Kazuhiro",
            "initials": "K",
            "lastname": "Shirozu"
        },
        {
            "affiliation": "Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.",
            "firstname": "Midoriko",
            "initials": "M",
            "lastname": "Higashi"
        },
        {
            "affiliation": "Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.",
            "firstname": "Ken",
            "initials": "K",
            "lastname": "Yamaura"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s40981-024-00706-3\n10.1136/heartjnl-2015-307467\n10.1136/heartjnl-2015-308788\n10.1016/j.ijcard.2015.03.344\n10.1016/j.ijoa.2016.08.004\n10.1016/j.ijoa.2021.103210\n10.1053/j.jvca.2022.07.009\n10.1093/eurheartj/ehr218\n10.1177/1753495X17737680\n10.1136/heartjnl-2014-306497\n10.1002/uog.8936\n10.1016/j.thromres.2004.08.004",
    "journal": "JA clinical reports",
    "keywords": [
        "Anesthetic management",
        "Anticoagulation therapy",
        "Fontan circulation",
        "Labor analgesia",
        "Mode of delivery"
    ],
    "methods": null,
    "publication_date": "2024-04-18",
    "pubmed_id": "38634932\n27220691\n26786817\n25828319\n27726918\n34425324\n35953405\n21873418\n29636807\n25539946\n21240915\n15507271",
    "results": null,
    "title": "Anesthetic management in pregnant women with Fontan circulation: a case series.",
    "xml": "<Element 'PubmedArticle' at 0x7885036270b0>"
}