{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T05:21:01Z","timestamp":1768540861050,"version":"3.49.0"},"reference-count":12,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2020,10,2]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>The coexistence of two complex physiologies such as Fontan and pregnancy is still not fully understood. We aim to add a unique and essential knowledge to help our colleagues in the management of Fontan patients that undergo pregnancy as well as the fetus and the placenta perfusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We analyse the coexistence of Fontan and pregnancy physiology on a complex case of a woman with hypoplastic left heart syndrome palliated with a univentricular repair who became pregnant, delivered very prematurely and had atypical placental findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Histopathological analysis of the placenta could help us to refine the understanding of Fontan physiology adaptation during pregnancy, predict women and fetal outcomes as well as to plan a better pre-pregnancy status. However, further evidence is needed in order to reach a more solid and unified conclusion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2019-001211","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T11:01:20Z","timestamp":1613732480000},"page":"e001211","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Case of placental insufficiency and premature delivery in a Fontan pregnancy: physiological insights and considerations on risk stratification"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6474-7013","authenticated-orcid":false,"given":"Maria Victoria","family":"Ordo\u00f1ez","sequence":"first","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0413-149X","authenticated-orcid":false,"given":"Giovanni","family":"Biglino","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"},{"name":"Bristol Medical School, University of Bristol, Bristol, UK"},{"name":"National Heart and Lung Institute, Imperial College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Caputo","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"},{"name":"Bristol Medical School, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Kelly","sequence":"additional","affiliation":[{"name":"Guy's King's and Saint Thomas' School of Medicine, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aarthi","family":"Mohan","sequence":"additional","affiliation":[{"name":"Obstetrics, St Michael's Hospital Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Trinder","sequence":"additional","affiliation":[{"name":"Obstetrics, St Michael's Hospital Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie L","family":"Curtis","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"key":"2025081612135822000_8.1.e001211.1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.ijcard.2019.02.002","article-title":"The placenta: a site of end-organ damage after Fontan operation. A case series","volume":"289","author":"Phillips","year":"2019","journal-title":"Int J Cardiol"},{"key":"2025081612135822000_8.1.e001211.2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-311763"},{"key":"2025081612135822000_8.1.e001211.3","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-307467"},{"key":"2025081612135822000_8.1.e001211.4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182874"},{"key":"2025081612135822000_8.1.e001211.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.117.004575"},{"key":"2025081612135822000_8.1.e001211.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.045"},{"key":"2025081612135822000_8.1.e001211.7","doi-asserted-by":"crossref","first-page":"4080","DOI":"10.12659\/MSM.907723","article-title":"Liver disease during pregnancy: a challenging clinical issue","volume":"24","author":"Mikolasevic","year":"2018","journal-title":"Med Sci Monit"},{"key":"2025081612135822000_8.1.e001211.8","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1017\/S1047951118001865","article-title":"Success in a Fontan pregnancy: how important is ventricular function?","volume":"29","author":"Ordonez","year":"2019","journal-title":"Cardiol Young"},{"key":"2025081612135822000_8.1.e001211.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.605"},{"key":"2025081612135822000_8.1.e001211.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.076"},{"key":"2025081612135822000_8.1.e001211.11","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.medengphy.2017.06.025","article-title":"Mathematical modelling of the maternal cardiovascular system in the three stages of pregnancy","volume":"47","author":"Corsini","year":"2017","journal-title":"Med Eng Phys"},{"key":"2025081612135822000_8.1.e001211.12","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1007\/s10237-019-01135-3","article-title":"A data-driven model to study utero-ovarian blood flow physiology during pregnancy","volume":"18","author":"Carson","year":"2019","journal-title":"Biomech Model Mechanobiol"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2019-001211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T19:14:05Z","timestamp":1755371645000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2019-001211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,2,19]]},"published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1136\/openhrt-2019-001211"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2019-001211","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2]]}}}