Successful Pregnancy Is Possible In Women With Congenital Heart Disease

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According to new guidance based on emerging data, pregnancy may now be possible for women with complex heart defects. Doctors have previously advised their patients with complex congenital heart defects against conception.

Pregnancy is a serious decision for women with complex congenital heart defects, Chair of the statement writing group and lecturer at UCLA School of Nursing in Los Angeles, Mary M. Canobbio, R.N. noted.

She added that they were previously advised not to get pregnant. Although, they make it very clear that it is not impossible, they caution that it is not going to be an easy path to pass through as they need to be handled with extreme care.

Changes accompanied by pregnancy greatly influence the heart and circulatory system. The blood volume in pregnancy increases by about 40 percent, cardiac output rises from 30 percent to almost 50 percent and the heart rate increases to 10-20 beats per minute. These chances can affect the heart function according to Canobbio.

This is a very risky situation for women with complex congenital heart defects. They are abnormalities that require immediate medical care at birth and care for the rest of their lives. The major issue for a doctor to consider is whether the patient's heart can manage the additional blood volume associated with pregnancy.

Another key issue is determining if the defect and any other related complications are under control. The most common complications are single ventricle defects, which may be accompanied by weakness or absence of one of the heart's two pumping chambers, reversal of the two main arteries leaving which carry blood away from the heart, so that blood that should will pump out reverse back to the heart, high blood pressure in the arteries of the lungs and critical narrowing of a valve on the left side of the heart, according to American Heart Association News.

Although, it depends on the peculiar complex heart defect, it is confirmed that some pregnant women have higher risk of heart failure and irregular heart rhythms which could also lead to a life-threatening rupture of the aorta or blockage or stiffening of a mechanical heart valve. Others may have a higher risk of miscarriages, premature birth or stillborn birth.

Some types of medications used to treat congenital heart defects, such as blood thinners, are also known to be harmful to the fetus, which may have to be switched during the early part of the pregnancy, while other drugs may be discontinued during pregnancy.

Researchers recommend that women with complex heart defects undergo a pre-natal medical counseling so as to be better informed of the risks that a pregnancy and delivery poses to her and her unborn child and also genetic counseling to give an insight on the chance that the baby might inherit a heart defect.

Furthermore, a delivery plan specific to a woman's condition is necessary to prepare the medical team for imminent issues during or after delivery. The plan could include inducing labor so experts are available during labor and delivery and utilizing an epidural with narcotics to limit the pregnant woman's urge to push so as to reduce the increased demands on the heart.

They also recommend that women with the condition are given expert care during their pregnancy and give birth in hospital with an experience cardiologist, a trained obstetrician in high-risk maternal-fetal medicine, heart surgeons and heart anesthesiologists, according to Medical Express.

The effects of pregnancy could continue for six weeks to six months, so regular check up on mother and child is expected to continue even after delivery. The new advice was published by the American Heart Association in its journal Circulation.