Heart Disease and Pregnancy: Be Wary

Having a heart condition will necessitate special care during pregnancy. The following information pertains to heart conditions and pregnancy.

What effect does pregnancy have on the heart?

Pregnancy puts your heart and circulatory system under stress. Your blood volume increases by 30 to 50 percent during pregnancy to nourish your growing baby, your heart pumps more blood per minute, and your heart rate increases.

Labor and delivery also increase the heart’s workload. During work, notably, when you push, your blood flow and blood pressure will fluctuate abruptly. It takes several weeks after childbirth for the stresses on the heart to return to its pre-pregnancy levels.

What are the dangers?

The risks vary according to the nature and severity of your heart condition. For instance:

Heart rhythm problems During pregnancy, minor abnormalities in heart rhythm are common. Typically, they are not causing, not cause for concern. If you require treatment for an arrhythmia, you will likely be given medication, just as if you weren’t pregnant.

Heart valve issues. Having a prosthetic heart valve or scarring or malformation of the heart or valves can increase the risk of pregnancy complications. If your valves are not functioning correctly, you may have difficulty tolerating the increased blood flow during pregnancy.

Moreover, artificial or abnormal valves increase the risk of a potentially fatal infection of the heart’s lining (endocarditis) and heart valves. Due to the need to adjust blood thinners and the possibility of life-threatening clotting (thrombosis) of heart valves, artificial mechanical ones pose serious risks during pregnancy. Using blood thinners can also endanger your developing child.

Heart failure due to congestive heart failure. With an increase in blood volume, congestive heart failure can worsen.

Congenital heart malformation. If you were born with a heart defect, your child has an increased risk of developing a heart defect. You may also be susceptible to heart problems during pregnancy and preterm birth.

Some heart conditions may be associated with more complications than others.

Certain heart conditions, particularly constriction of the mitral or aortic valves, can threaten the life of the mother or child. Before attempting to conceive, certain heart conditions may necessitate effective treatments, such as heart surgery.

Women with Eisenmenger’s syndrome or high blood pressure that affects the arteries in the lungs and the right side of the heart are discouraged from becoming pregnant (pulmonary hypertension).

What about pharmaceuticals?

Medication taken during pregnancy can have adverse effects on the fetus. However, the benefits typically outweigh the risks. If you require a prescription to treat your heart condition, your doctor will prescribe the safest medication at the optimal dose.

Advice from and for Psoriatic Arthritis Patients.

Take the prescribed medication exactly as directed. Do not stop taking the medication on your own or alter the dosage.

How can I get ready for pregnancy?

Schedule an appointment with your cardiologist and the health care provider who will manage your pregnancy before attempting conception. You will likely be referred to an obstetrician specializing in extremely high-risk pregnancies (maternal-fetal medicine specialist). You may also wish to consult with other healthcare team members, such as your primary care physician.

Before you become pregnant, your medical team will assess how well you manage your heart condition and consider any necessary treatment modifications.

During pregnancy, certain medications used to treat heart conditions are not administered. Depending on the circumstances, your healthcare provider may adjust the dosage or make a substitution and explain the associated risks.

What can I anticipate from prenatal visits?

During pregnancy, you will see your healthcare provider frequently. At each visit, your weight and blood pressure will likely be measured, and you may be required to undergo frequent blood and urine tests.

The frequency of your prenatal visits to your cardiologist will depend on the severity of your heart condition. Your healthcare provider may use the following tests to evaluate your heart’s function:

Echocardiogram. This type of ultrasound creates images of the heart and its structures using sound waves.

Electrocardiogram. This test measures the electrical activity of your heart.

How can I ensure that my child is healthy?

Your healthcare provider will monitor the development of your baby throughout your pregnancy. Specialized ultrasounds can detect fetal heart abnormalities, and routine ultrasounds can be used to monitor your baby’s growth. Your infant may also require monitoring or treatment after delivery.

What can I do to avoid complications?

Taking care of yourself is the most effective way to care for your child. For instance:

  • Keep your prenatal appointments. Regularly visit your healthcare provider throughout your pregnancy.
  • Take your medication exactly as directed. Your physician will prescribe the most certain medicines at the optimal dosage.
  • Get sufficient rest. If possible, nap daily and avoid strenuous physical activity.
  • Watch your weight gain closely. Your baby’s growth and development are aided by gaining the ideal weight. Excessive weight gain places additional strain on the heart.
  • Control anxiety. Ask questions about your progress. Learn what to anticipate during labor and delivery. Understanding the situation can help you feel more at ease.
  • Know what is prohibited. Avoid using tobacco, alcohol, caffeine, and illegal substances.

What symptoms or signs should I report to my physician?

Contact your healthcare provider if you experience any concerning signs or symptoms, including:

  • Difficulty in respiration
  • Breathlessness during exertion or at rest
  • Heart palpitations, a rapid heart rate, or an irregular pulse are symptoms of cardiovascular disease.
  • Chest pain
  • A bloody cough or nighttime coughing

What about pregnancy and childbirth?

Your healthcare provider may suggest that you deliver your baby at a facility specializing in high-risk pregnancies. If there are concerns regarding your heart or circulation, or if you require the presence of specific specialists during labor, your labor may be induced.

During labor, specialized equipment may be used to monitor you. Your heart rate and rhythm may need to be monitored during labor and delivery.

Your contractions and the heart rate of your baby will be continuously monitored. Instead of lying on your back, you may be instructed to lie on your side and bring one knee to your chest.

Your doctor may recommend that you receive pain medication through a catheter inserted into your spine (epidural) or an injection into your spine (spinal block) to alleviate pain-related stress. If you give birth vaginally, your healthcare provider may limit your pushing by using forceps or a vacuum extractor to assist in the delivery.

If you are at risk for endocarditis, you may receive antibiotic treatment before and following delivery.

It is uncommon for a heart condition to necessitate a C-section. Special precautions will be taken to monitor your heart function during delivery if you develop an obstetrical problem requiring a C-section. If you have certain forms of severe cardiac disease during pregnancy, your physician may recommend scheduling a date to induce labor under controlled conditions.

Will I have the ability to breastfeed my child?

The majority of women with heart conditions are encouraged to breastfeed, including those who take medication. Discuss potential treatment modifications with your healthcare provider in advance.

If you have a congenital heart defect that significantly increases your risk of endocarditis, your doctor will likely discuss the possibility of developing mastitis while breastfeeding. This relatively common infection may pose a unique chance in your case. In some instances, pumping and feeding breast milk may be recommended.

last updated: July 2017

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