A woman in her mid-20s with repaired congenital heart disease (CHD) delivered a 33-week neonate in 2024 following preterm labor and a 24-week neonate in 2025 for non-reassuring fetal heart tones. Placental examination in both cases revealed grossly abnormal, red-brown discolored membranes with a circumvallate insertion. Histologic evaluation demonstrated diffuse chorioamniotic hemosiderosis (DCH) in both cases. This report describes a novel case of recurrent DCH in a mother with CHD and proposes that Fontan physiology may contribute to impaired uteroplacental perfusion, increasing the risk for marginal hemorrhage.
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