Keeping an eye on mom: managing heart disease in pregnancy

If you’re one of the millions of American women with heart disease, you may have questions about whether you can safely conceive and how heart disease in pregnancy is managed.

Let’s start with the most important message: In many cases, it’s possible to have a safe pregnancy and a healthy baby if you have heart disease. Your OB/GYN, cardiologist and other Touro medical providers can work together to provide you with individualized guidance for your pregnancy journey from conception to birth.

Want to learn some general information about heart disease in pregnancy? Today’s blog will fill you in on some of the details.

The different types of heart disease

When you hear someone talk about heart disease, you may think it’s a specific medical condition. Actually, heart disease is an umbrella term that encompasses a number of different conditions affecting the cardiovascular system. This includes both the heart itself and the blood vessels responsible for moving blood to and from the heart.

In many cases, women who have heart disease have some sort of congenital condition, meaning it was present at birth, even if not detected until much later. Common adult congenital heart disease conditions include:

• Congenital heart defects, such as atrial septal defect, aortic coarctation, ventricular septal defect or Tetralogy of Fallot
• Patent ductus arteriosus, which affects how blood flows to and through the lungs
• Problems with a heart valve, such as aortic stenosis (which affects the aortic valve) or mitral stenosis or mitral valve prolapse (which affect the mitral valve)

Pregnant women may also have other pre-existing heart conditions, meaning they had them prior to pregnancy. These conditions can range from common issues, such as high blood pressure, to more serious concerns, such as heart rhythm disorders, Marfan syndrome and congestive heart failure.

If you have any type of heart health issue, it’s important to talk with your medical providers before becoming pregnant. They can advise about whether pregnancy is safe for you, potential complications during pregnancy and care during pregnancy.

How pregnancy can impact the heart

Pregnancy itself challenges the heart. For one, blood volume rises during the beginning stages of pregnancy, increasing by about half. That makes the heart work harder to pump blood efficiently.

In some cases, even if you didn’t have high blood pressure before pregnancy, you may develop it during your pregnancy. If your blood pressure rises to unhealthy levels but you don’t have protein in your urine or other signs of kidney and heart problems, it’s diagnosed as gestational hypertension. If your blood pressure rises after 20 weeks of pregnancy and you also have protein in your urine or other signs of kidney and heart problems, this is called preeclampsia.

Labor and delivery can also stress your heart. As you labor to deliver and your uterus contracts, your heart rate and blood pressure may increase.

Occasionally, other heart problems can occur during pregnancy or in the days and weeks afterward. These heart issues related to pregnancy include a serious condition known as peripartum cardiomyopathy. This pregnancy-related type of dilated cardiomyopathy causes the heart chambers to enlarge, making them unable to pump normally.

When women who have heart conditions become pregnant, their pregnancies are often identified as high risk. That doesn’t mean you can’t have a safe pregnancy—it simply means the risk of complications may be higher.

Having heart defects may increase your risk of developing complications during pregnancy, such as anemia or hemorrhage, so you will be carefully monitored at every stage by maternal fetal medicine specialists. You’ll likely undergo additional screenings and tests, along with more frequent checkups.

In the end, our goal is the same as yours: a safe pregnancy to keep both mom and baby healthy.

Since 1922, we’ve been the hospital where babies come from. Ready to welcome your own new addition? Learn more about our Family Birthing Center.