VanHise Katherine, Li Linda, Smith Emily, Condon Niamh
Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Department of Obstetrics and Gynecology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
BMJ Case Rep. 2018 Jan 5;2018:bcr-2017-222684. doi: 10.1136/bcr-2017-222684.
In cardiac physiology, single ventricle typically refers to the presence of a dominant systemic ventricle along with a hypoplastic ventricle. The Fontan operation is used to repair the single ventricle by directing deoxygenated systemic venous flow to the pulmonary arterial circulation. Normal pregnancy physiology, particularly increased intravascular volume, increased heart rate, increased cardiac output, hypercoagulability and decreased systemic vascular resistance, can exacerbate cardiac disease in patients with Fontan circulation, leading to pregnancy complications. Despite the known risks, there are limited data addressing the question of anticoagulation in pregnant patients with Fontan physiology. Herein we present the case of a Fontan patient who had a successful pregnancy and delivery, and developed an embolic stroke in the postpartum period.
在心脏生理学中，单心室通常是指存在一个占主导地位的体循环心室以及一个发育不全的心室。Fontan手术用于通过将脱氧的体循环静脉血流导向肺循环来修复单心室。正常的妊娠生理，尤其是血管内容量增加、心率加快、心输出量增加、高凝状态和体循环血管阻力降低，会使患有Fontan循环的患者的心脏病加重，导致妊娠并发症。尽管存在已知风险，但关于Fontan生理的妊娠患者抗凝问题的数据有限。在此，我们报告一例Fontan患者，该患者成功妊娠并分娩，产后发生了栓塞性中风。
