Although perinatal complications during pregnancy in women with Congenital Heart Disease (ACHD) are well known, the pathophysiological mechanisms are still to be elucidated. As the placenta is the interface between mother and fetus, its analysis might help to better understand their interactions and identify risk factors for complications.

We hypothesize that abnormal findings would be more frequent in placentas of women with CHD than in those without cardiac disease. The main objective of this study is to compare the incidence of placental abnormalities (PA) in ACHD versus controls women.

The present proposal is to conduct a prospective, multicentric, national, 2-years (2023–2024) cohort study (research involving human type III), in order to analyze Doppler imaging and histological placentas, and compare findings in a group of women with ACHD versus a group without. The secondary objectives of the study are to assess the association between PA and the occurrence of maternal cardiovascular, fetal and/or perinatal complications, and to assess risk factors for PA or maternal/fetal events (Fig. 1).

Placentas of ACHD would have significantly (P<0.05) more abnormalities and these would correlate with the occurrence of complications.

Description of PA could help to elucidate the pathophysiological mechanisms and eventually propose preventive therapeutic strategies of fetal and/or neonatal complications. Risk factors could be stratified according to the type of heart disease (as the mWHO score) and could allow to propose a novel risk-score of pregnancy in women with CHD.