{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:14:42Z","timestamp":1787505282502,"version":"build-2736575974"},"reference-count":30,"publisher":"BMJ","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:p>\n                    <jats:bold>Objectives:<\/jats:bold>\n                    To evaluate the outcome of pregnancy in women after Fontan palliation and to assess the occurrence of infertility and menstrual cycle disorders.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design and patients:<\/jats:bold>\n                    Two congenital heart disease registries were used to investigate 38 female patients who had undergone Fontan palliation (aged 18\u201345 years): atriopulmonary anastomosis (n \u200a=\u200a 23), atrioventricular connection (n \u200a=\u200a 5) and total cavopulmonary connection (n \u200a=\u200a 10).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Six women had 10 pregnancies, including five miscarriages (50%) and one aborted ectopic pregnancy. During the remaining four live-birth pregnancies clinically significant complications were encountered: New York Heart Association class deterioration; atrial fibrillation; gestational hypertension; premature rupture of membranes; premature delivery; fetal growth retardation and neonatal death. Four of seven women who had attempted to become pregnant reported female infertility: non-specified secondary infertility (n \u200a=\u200a 2), uterus bicornis (n \u200a=\u200a 1) and related to endometriosis (n \u200a=\u200a 1). Moreover, several important menstrual cycle disorders were documented. In particular, the incidence of primary amenorrhoea was high (n \u200a=\u200a 15, 40%), which resulted in a significant increase in age at menarche (14.6 (SD 2.1) years, p &lt; 0.0001, compared with the general population).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Women can successfully complete pregnancy after adequate Fontan palliation without important long-term sequelae, although it is often complicated by clinically significant (non-)cardiac events. In addition, subfertility or infertility and menstrual disorders were common.\n                  <\/jats:p>","DOI":"10.1136\/hrt.2005.085407","type":"journal-article","created":{"date-parts":[[2006,2,1]],"date-time":"2006-02-01T11:32:32Z","timestamp":1138793552000},"page":"1290-1294","source":"Crossref","is-referenced-by-count":149,"title":["Pregnancy and delivery in women after Fontan palliation"],"prefix":"10.1136","volume":"92","author":[{"given":"W","family":"Drenthen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P G","family":"Pieper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J W","family":"Roos-Hesselink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W A","family":"van Lottum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A 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