Are There Special Considerations When Pregnant with a Heart Condition?
There are over 60 million women in the United States living with a heart condition. While going through life with a heart condition is certainly a common occurrence and can be managed with the proper care from a cardiologist, there are certain times when your condition may impact certain life decisions, such as pregnancy. Heart disease accounts for over 25% of pregnancy-related deaths, making it the leading cause of maternal mortality in the United States.
The good news is most women with a heart condition are able to become pregnant and deliver a healthy baby if they receive the proper care from a cardio obstetrics (cardio OB) team that includes a cardiologist and maternal fetal specialist. If you’re considering having a baby, it’s important to understand the ways in which your heart condition will impact your pregnancy, the risks associated with your condition and the special care required to safeguard the health of both you and your baby.
The following overview will help you understand the considerations associated with becoming pregnant when you have a heart condition. Keep in mind that the decision regarding whether to move forward with family plans should always be made in conjunction with the guidance of your cardiologist to optimize your health and minimize the risk of additional complications.
How Does Pregnancy Affect Your Heart?
Pregnancy causes your body to undergo a variety of changes in order to nurture the growth of a fetus and provide it with the oxygen and nutrients it needs. Some of these changes can place additional stress on your cardiovascular system and force your heart to work harder. Here are some of the ways pregnancy can affect your heart:
- Increased Blood Volume – Blood volume increases by 30-50% to provide the fetus with proper nourishment.
- Increased Heart Rate – Your heart rate increases 10-20 beats per minute during pregnancy, reaching its highest rate during the final trimester.
- Increased Cardiac Output – The increase in blood volume and heart rate also impacts the amount of blood your heart pumps per minute, called your cardiac output. It can increase as much as 30-50% during pregnancy. This figure is even higher for women pregnant with twins.
- Heart Palpitations – Heart palpitations are a common symptom experienced during pregnancy. While they are typically not a cause for concern, they should be monitored, especially if you have a pre-existing heart condition.
- Changes in Blood Pressure and Blood Flow – Sudden changes in blood flow and blood pressure occur during labor, especially while pushing out the baby. These shifts can create additional stress on the heart.
Potential Risks to Monitor if You Have a Heart Condition
The risks you may experience during pregnancy can vary based on the type and severity of your heart condition. Some of the most common potential risks to be aware of include:
- Increased risk of arrythmia
- Complications such as increased risk of infection of the heart lining and heart valves or increased risk of blood clots may occur if you have a pre-existing heart valve condition or an artificial heart valve
- Increased risk of heart failure
- Increased risk of thromboembolic events
- Increased risk that your baby will develop a congenital heart defect (if you were born with a heart condition)
While most risks can be safely managed with proper planning and care from your cardio OB team throughout pregnancy, there are certain conditions that may pose very serious risks for the mother or the baby. Pregnancy may not be recommended if you have one of the following heart conditions:
- Moderate to severe heart failure
- Serious narrowing of the aortic or mitral heart valves
- Ongoing heart muscle weakness that developed late in a prior pregnancy or shortly after childbirth
- Aortic valve with only two flaps combined with an enlarged aorta
- Pulmonary hypertension
- Eisenmenger’s syndrome
- A birth defect that results in a narrowing of your body’s largest blood vessel
Proper Planning Is Essential for Managing Your Heart Condition During Pregnancy
While it’s generally safe for women with heart conditions to have children, it’s important to carefully plan your pregnancy in conjunction with your cardio OB team to minimize the risks associated with your heart condition. This planning includes:
- Comprehensive risk assessment
- Imaging and diagnostic studies
- Evaluation of medication usage
Based on this planning, your cardio OB team may recommend changes to the way you manage your heart condition, including changes to medication regimens, to minimize the risk of complications during pregnancy.
In addition, you’ll need to be closely monitored throughout your pregnancy to track your heart function, identify any symptoms that may be a sign of a potential complication, and ensure the fetus is developing properly. It’s common for medication regimens to be adjusted periodically during pregnancy to ensure the safety of the mother and fetus. Similarly, close monitoring will be required for the first few weeks after delivery to ensure your body is adjusting to the changes that occur during this stage of the process.
Tips for Preventing Pregnancy Complications with a Heart Condition
While careful pre-pregnancy planning and close monitoring throughout your pregnancy is critical, there are also some steps you can take throughout your pregnancy to minimize the risk of serious complications. Most of these items fall under the category of “taking proper care of yourself” and include:
- Attend all scheduled appointments with your cardio OB team
- Take your medications as prescribed
- Take steps to manage anxiety and stress
- Manage your weight gain to avoid placing additional strain on your heart
- Avoid smoking, drinking, recreational drug use, and other actions that can be detrimental to the health of you and the fetus
- Report any adverse symptoms to your cardio OB team as soon as they develop
South Denver Cardiology Can Help You Manage Your Heart Condition While Pregnant
At South Denver Cardiology, we provide comprehensive cardo obstetrics care to patients managing a pregnancy with a heart condition. Our cardio OB team is led by Dr. Josephine Chou Catanzaro. Dr. Chou has extensive experience in the field of cardo obstetrics. Prior to joining the South Denver Cardiology team, she spent five years at Yale University where she established their cardio obstetrics program. Dr. Chou also spent two years at the University of Colorado as their director of cardio obstetrics. Her extensive expertise in this specialized field of cardiology provides our patients with the exceptional care they need when trying to manage a heart condition through pregnancy.
Contact us today to schedule an appointment. South Denver Cardiology serves patients in South Denver, Littleton and the surrounding areas.
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