title: Complex congenital heart disease in a complicated and precious pregnancy.
abstract: A single ventricle is a rare congenital heart disease that accounts for less than 1% of all congenital heart diseases. A woman was assessed in our obstetric clinic for the first time at the gestational age of 28 weeks and found to have placental bleeding. She also had complex congenital heart disease and atrial fibrillation requiring anticoagulation. Echocardiography revealed double-inlet single ventricle with right and left atrioventricular valves entering into this chamber and levo-transposition of the great arteries. After an extensive discussion with the patient regarding the risks and benefits of anticoagulation including risk of stroke, the agreed plan was to start her on intravenous heparin with close observation and to continue pregnancy for at least 32 weeks in order to reduce the postpartum risk for the fetus. The pregnancy progressed without any further complications and the patient had elective caesarean section at 33 weeks of gestation and delivered a healthy baby boy.
authors.affiliation: King Abdul Aziz Medical City for National Guard, Riyadh, Central Region, Saudi Arabia.
authors.forename: Zeinelabdien
authors.initials: Z
authors.lastname: Elsherif
authors.affiliation: Department of Cardiology, King Abdul Aziz Medical City for National Guard, Riyadh, Central Region, Saudi Arabia.
authors.forename: Naveed
authors.initials: N
authors.lastname: Mahmood
authors.affiliation: Department of Obstetrics and Gynecology, King Abdul Aziz Medical City for National Guard, Riyadh, Central Region, Saudi Arabia.
authors.forename: Shazia
authors.initials: S
authors.lastname: Jamil
authors.affiliation: Department of Obstetrics and Gynecology, King Abdul Aziz Medical City for National Guard, Riyadh, Central Region, Saudi Arabia.
authors.forename: Hadeel
authors.initials: H
authors.lastname: Wagas
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006352:Heart Ventricles / Q000002:abnormalities*; D006470:Hemorrhage / Q000188:drug therapy; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D010922:Placenta Diseases / Q000188:drug therapy; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin