Abstract
This manuscript reviews a complex case of a gravida 3, para 2 (G3P2) parturient with Fontan physiology, complicated by suspected placenta accreta spectrum (PAS) versus massive subchorionic thrombohematoma (MST), presenting with placental abruption at 32 weeks of gestation. This case highlights the intricacies of managing pregnancy in patients with single ventricle physiology, underscoring the necessity for comprehensive, coordinated care across specialties to optimize maternal and fetal outcomes.