Bleeding and thrombotic risk in pregnant women with Fontan physiology

Therapeutic heparin use during pregnancy in women with Fontan physiology was significantly associated with bleeding events compared to no antithrombotic therapy (OR 15.6, 95% CI 1.88-129, p=0.006).

Effect: adverse; OR 15.6; CI: 95% CI 1.88 to 129

Vitamin K antagonist use during pregnancy in women with Fontan physiology was significantly associated with bleeding events compared to no antithrombotic therapy (OR 11.7, 95% CI 1.06-130, p=0.032).

Effect: adverse; OR 11.7; CI: 95% CI 1.06 to 130

Aspirin use during pregnancy in women with Fontan physiology was not significantly associated with increased bleeding risk compared to no antithrombotic therapy (OR 5.41, 95% CI 0.73-40.4, p=0.067).

Effect: null; OR 5.41; CI: 95% CI 0.73 to 40.4

Prophylactic dose heparin use during pregnancy in women with Fontan physiology was not significantly associated with increased bleeding risk compared to no antithrombotic therapy (OR 4.68, 95% CI 0.48

Effect: null; OR 4.68; CI: 95% CI 0.488 to 44.9

The observed thrombosis rate of 2.8% in pregnant Fontan patients on various antithrombotic regimens was not higher than the 4-33% rate reported outside pregnancy in this population, suggesting current

Effect: improvement; 2.8% thrombosis rate (3/108 pregnancies)

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: adverse; 35.2% (38/108 pregnancies with bleeding)