It is vital for a pregnant woman with congenital heart disease to have strong support from a multidisciplinary team experienced with her heart condition and the effect of pregnancy on that condition.
Q: I have congenital heart disease, and I am thinking about getting pregnant. How should I prepare in order to be sure I am healthy enough to carry my baby to term?
A: Most women with congenital heart disease are absolutely able to experience a successful pregnancy. It is, however, important that you discuss pregnancy with your cardiologist before becoming pregnant, as congenital heart disease in women presents various risks to not only a mother but to a baby, as well. If you have congenital heart disease, there can be confusing and misleading information on the care you should receive.
It is vital for a pregnant woman with congenital heart disease to have strong support from a multidisciplinary team experienced with her heart condition and the effect of pregnancy on that condition. This team will need to assess the woman's needs and tailor pregnancy and delivery plans to ensure that careful, thorough care and monitoring occurs throughout the entire pregnancy and postpartum period.
Before becoming pregnant, a complete cardiac evaluation should be done. The evaluation may be as simple as a medical history and physical examination. With more complex congenital heart disease, however, the evaluation may also include a wider spectrum of tests. Some diagnostic tests are safer outside of pregnancy, and interventions can sometimes be recommended to improve the safety of a pregnancy.These evaluations will determine the strength and health of the mother in the hopes of achieving the healthiest outcome for mother and baby. For women who become pregnant prior to an evaluation, an assessment during pregnancy can be vital in directing care for the remainder of the pregnancy, as well as a safe delivery and postpartum care.
It is also important for women to discuss their medication use with experts in cardiology, OB-GYN and primary care before becoming pregnant, since some medications can be harmful to the baby. Moms with heart disease may be advised to continue heart medications when this is the healthiest option for her - and for the baby.
- May Ling Mah, M.D., and Sharon L. Roble, M.D., are cardiologists with the Columbus Ohio Adult Congenital Heart Disease (COACH) Program at Nationwide Children's Hospital.