Heart conditions and pregnancy: Know the risks

Pregnancy stresses your heart and circulatory system, but many women who have heart conditions deliver healthy babies. Know the risks — and how to help prevent complications.

By Mayo Clinic staff

If you have a heart condition, you'll need special care during pregnancy. Here's what you need to know about heart conditions and pregnancy.

How does pregnancy affect the heart?

Pregnancy stresses your heart and circulatory system. During pregnancy, your blood volume increases by 30 to 50 percent to nourish your growing baby. The amount of blood your heart pumps each minute also increases by 30 to 50 percent. Your heart rate increases as well. These changes cause your heart to work harder.

Of course, labor and delivery add to your heart's workload, too. During labor — particularly when you push — you'll experience abrupt changes in blood flow and pressure. When your baby is born, decreased blood flow through the uterus also stresses your heart.

What are the risks?

The risks depend on the nature and severity of the underlying heart condition. For example:

  • Heart rhythm issues. Minor abnormalities in heart rhythm are common during pregnancy. They're not usually cause for concern.
  • Heart valve issues. If you have an artificial heart valve or your heart or valves are scarred or malformed, you might face an increased risk of complications during pregnancy. If your valves aren't working properly, you might have trouble tolerating the increased blood flow. In addition, artificial or abnormal valves carry an increased risk of endocarditis — a potentially life-threatening infection of the lining of the heart and heart valves. Mechanical artificial heart valves also pose serious risks during pregnancy due to the need to adjust use of blood thinners and the potential for life-threatening clotting (thrombosis) of heart valves.
  • Congestive heart failure. As blood volume increases, congestive heart failure can get worse.
  • Congenital heart defect. If you were born with a heart problem, your baby has a greater risk of developing some type of heart defect, too. You may also be at risk of premature delivery.

Do some heart conditions cause more complications than others do?

Certain heart conditions, including problems with the mitral valve or aortic valve, can pose life-threatening risks for mother or baby. Depending on the circumstances, some heart conditions might require major treatments — such as heart surgery — before you try to conceive. The risk of pregnancy in women who have Eisenmenger's syndrome — a rare congenital condition — or pulmonary hypertension — a condition characterized by high blood pressure that affects the arteries in the lungs and the right side of the heart — is so high that pregnancy isn't recommended.

What about medication?

Any medication you take during pregnancy can affect your baby. Often the benefits outweigh the risks, however. If you need medication to control your heart condition, your health care provider will prescribe the safest medication at the most appropriate dose. Take the medication exactly as prescribed. Don't stop taking the medication or adjust the dose on your own.

What should I do to prepare for pregnancy?

Before you try to conceive, schedule an appointment with your cardiologist and the health care provider who'll be handling your pregnancy. Also meet with other members of your health care team, such as your family doctor. Your medical team will evaluate how well you're managing your heart condition and consider any treatment changes you might need to make before pregnancy begins.

Certain medications commonly used to treat heart conditions aren't used during pregnancy. Depending on the circumstances, your health care provider might adjust the dosage or make a substitution and explain the risks involved.

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References
  1. Pregnancy and heart disease. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4688. Accessed March 31, 2011.
  2. Fetal echocardiography/Your unborn baby's heart. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/SymptomsDiagnosisofCongenitalHeartDefects/Fetal-Echocardiography-Your-Unborn-Babys-Heart_UCM_315640_Article.jsp. Accessed March 31, 2011.
  3. Heart disorders in pregnancy. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec18/ch261/ch261i.html. Accessed March 31, 2011.
  4. Impact on females. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Impact-on-Females_UCM_307113_Article.jsp. Accessed March 31, 2011.
  5. Risk factors present before pregnancy. The Merck Manuals: Home Edition for Patients and Caregivers. http://www.merck.com/mmhe/sec22/ch258/ch258b.html. Accessed March 31, 2011.
  6. Siu SC, et al. Heart disease and pregnancy. Heart. 2001;85:710.
  7. Perloff JK. Pregnancy in women with congenital heart disease: General principles. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  8. DeCara JM, et al. Management of heart failure in pregnancy. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  9. Arafeh JM, et al. Cardiac disease in pregnancy. Critical Care Nursing Quarterly. 2006;29:32.
  10. Infective endocarditis (previously referred to as bacterial endocarditis). American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4436. Accessed March 31, 2011.
  11. Gaasch WH, et al. Management of pregnant women with prosthetic heart valves. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  12. Arendt KW, et al. Obstetric anesthetic management of women with acquired or congenital heart disease. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
  13. Cunningham FG, et al. Williams' Obstetrics. 23rd ed. New York, N.Y.: The McGraw-Hill Companies; 2010. http://www.accessmedicine.com/content.aspx?aid=6040459. Accessed June 2, 2011.
  14. Congenital cardiovascular defects. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4565. Accessed April 6, 2011.
  15. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. April 12, 2011.
PR00124 July 30, 2011

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