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Finding
Finding
adverse
Bleeding complications occurred in 35.2% of pregnancies in women with Fontan physiology, with 13% of bleeds being potentially life-threatening, indicating high haemorrhagic risk in this population.
| Effect size | 35.2% (38/108 pregnancies with bleeding) |
| Comparator | General pregnant population bleeding rates; non-Fontan pregnant patients on ACM |
| Effect summary | adverse; 35.2% (38/108 pregnancies with bleeding) |
| Adverse events | bleeding complications 35.2%, potentially life-threatening bleeds 13% |
| Effect modifiers | [{"modifier": "trimester", "interaction_p": "p=0.025", "direction": "amplifies", "stratum_details": "Third trimester: OR 3.3 (95% CI 1.39-9.63, p=0.025); Second trimester: OR 1.27 (95% CI 0.436-3.69, p=0.62, NS)", "plain_language": "Bleeding risk more than tripled in the third trimester, which is also when delivery happens and when blood thinners are most problematic.", "annotation_notes": "Third trimester was the most common time for bleeding (47.6% of events)"}, {"modifier": "thrombotic risk category", "interaction_p": "p=0.038", "direction": "amplifies", "stratum_details": "High thrombotic risk (>=2 risk factors): OR 2.49 (95% CI 1.05-5.89, p=0.038)", "plain_language": "Women who were at higher risk for blood clots also had about 2.5 times the bleeding risk, creating a dangerous catch-22 where the women who most need blood thinners are also most likely to bleed.", "annotation_notes": "28 pregnancies (25.9%) were in women at high thrombotic risk"}] |
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Source
PMC10367127
Bleeding and thrombotic risk in pregnant women with Fontan physiology