{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T10:19:15Z","timestamp":1766139555364,"version":"3.48.0"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Shone syndrome is a complex congenital cardiac condition describing multiple obstructive left-sided heart lesions. We present four cases of pregnancies in three women with Shone syndrome and the role for preconception counseling and multidisciplinary delivery planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>Single-centre chart review of pregnant women with Shone syndrome over 5 years, including maternal and foetal outcomes and delivery plans. There were four deliveries amongst three nulliparous women ages 25\u201331 years with prior surgical repairs for Shone syndrome. Multidisciplinary delivery planning occurred in the third trimester of each pregnancy. There were four term deliveries (vaginal deliveries for three, caesarean for one) with cardiac monitoring and adjustments to typical peripartum protocols. One patient required acute intensive care unit care for postpartum tachycardia and pulmonary oedema, and another required medical management of gestational hypertension. One infant required neonatal intensive care for respiratory distress. All patients and infants were discharged by postpartum Day 3 without early readmission. One patient developed acute decompensated heart failure at 7 months postpartum and died following cardiac arrest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Women with Shone syndrome possess multiple obstructive cardiac lesions often considered in isolation as high risk for cardiac events in pregnancy, though not completely captured in risk prediction algorithms and with heterogeneity requiring case-by-case management. Multidisciplinary delivery planning including cardiologists, obstetricians, and obstetric anaesthesiologists can safely navigate immediate maternal and neonatal care needs. Pre-conception counselling and close follow-up are imperative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf587","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T13:01:24Z","timestamp":1765630884000},"source":"Crossref","is-referenced-by-count":0,"title":["Case reports of pregnancies in women with Shone syndrome: role for multidisciplinary planning"],"prefix":"10.1093","volume":"9","author":[{"given":"Joel","family":"Tiller","sequence":"first","affiliation":[{"name":"College of Medicine, Medical University of South Carolina , 268 Calhoun St., Charleston, SC 29425 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rochelle","family":"Judd","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Medical University of South Carolina , 96 Jonathan Lucas St. Ste. 601, MSC 617, Charleston, SC 29425 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine H","family":"Hatter","sequence":"additional","affiliation":[{"name":"Department of Anesthesia & Perioperative Medicine, Medical University of South Carolina , 25 Courtenay Drive, Suite 4200 MSC 240, Charleston, SC 29425 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza","family":"McElwee","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of South Carolina , 171 Ashley Ave., Charleston, SC 29425 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gregg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Medical University of South Carolina , 96 Jonathan Lucas St. Ste. 601, MSC 617, Charleston, SC 29425 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8536-9899","authenticated-orcid":false,"given":"Stephanie S","family":"Gaydos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Cardiology, Medical University of South Carolina , 10 McClennan Banks Dr., MSC 915, Charleston, SC 29425 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"2025121905153195900_ytaf587-B1","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/0002-9149(63)90098-5","article-title":"The developmental complex of \u201cparachute mitral valve,\u201d supravalvular ring of left atrium, subaortic stenosis, and coarctation of aorta.","volume":"11","author":"Shone","year":"1963","journal-title":"Am J 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Hagen","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2025121905153195900_ytaf587-B8","doi-asserted-by":"crossref","first-page":"e019006","DOI":"10.1161\/JAHA.120.019006","article-title":"Genetic etiology of left-sided obstructive heart lesions: a story in development.","volume":"10","author":"Parker","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2025121905153195900_ytaf587-B9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.32604\/chd.2022.017366","article-title":"Pregnancy in patients with Shone complex: a single-center case series.","volume":"17","author":"Gardner","year":"2021","journal-title":"Congenit Heart Dis"},{"key":"2025121905153195900_ytaf587-B10","doi-asserted-by":"crossref","first-page":"342","DOI":"10.4097\/kja.20181","article-title":"Anesthetic management of a parturient with Shone\u2019s syndrome\u2014a case report with review of literature.","volume":"74","author":"Bhatia","year":"2021","journal-title":"Korean J 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