Congenital heart disease in pregnancy: Journey of Two Hearts Beating In One Body

Congenital heart disease in pregnancy (CHD) is a condition that affects the normal functioning of the heart from birth.

Pregnancy can be challenging for women with CHD, as the added physical strain on the heart can lead to an increased risk of complications.

However, with proper management and close monitoring by a multidisciplinary team of healthcare professionals, many women with CHD can safely carry their pregnancy to term. 

In this article, we will explore the risks associated with CHD and pregnancy, as well as the recommended management strategies for women with CHD who are pregnant or planning to become pregnant.

Understanding Congenital heart disease in pregnancy and Its Impact

CHD is a common congenital disability, affecting approximately 1 in every 100 newborns. 

There are many different types of CHD, ranging from minor defects that do not require treatment to be complex and life-threatening conditions that require surgery.

Pregnancy can be a physically demanding time for any woman, but it can be particularly challenging for women with Congenital heart disease in pregnancy. 

The increased blood flow and volume required to support the growing fetus can strain the heart, leading to complications such as heart failure, arrhythmias, and cardiac arrest.

Also, CHD can impact a woman’s ability to carry a pregnancy to term, as well as the health of the mother and fetus. 

Women with CHD may be at increased risk for premature delivery, gestational diabetes, and other pregnancy-related complications.

When to see a cardiologist?

If you’re experiencing symptoms related to heart disease, it’s recommended to see a cardiologist. 

The following are some of the signs and symptoms that suggest you may need to see a cardiologist:

• Chest discomfort [1] [2]
• Shortness of breath [1] [2] [3]
• Swelling in the legs [1] [2]
• High blood pressure [2]
• Abnormally fast or slow heart rate [2]
• Dizziness or fainting [2] [3]
• Heart palpitations, a feeling like your heart is racing very fast [1]
• Chest discomfort or indigestion that’s not going away [1]
• Strong family history of premature heart disease or cardiac death [2]
• Leg pain or ulcers resulting from blood vessel diseases [2]
• Chronically elevated blood pressure [3]

See a cardiologist if you’re experiencing any of these symptoms to determine if a heart condition is a cause and receive proper treatment.

Managing Congenital heart disease in pregnancy

The key to successfully managing CHD during pregnancy is close monitoring and careful management by a team of healthcare professionals. 

This team should include a cardiologist with experience in CHD, an obstetrician, and a midwife or nurse practitioner.

A comprehensive evaluation of the woman’s Congenital heart disease in pregnancy, including an assessment of her heart function and the potential impact on her pregnancy, should be performed before conception. 

This evaluation will help the healthcare team determine the best management strategies for the woman, including any necessary medications or interventions.

Once the woman is pregnant, continue regular prenatal care with close monitoring of both the mother and the fetus. 

Prenatal care may include additional prenatal testing, such as fetal echocardiography, to assess the fetus’s health and ensure that potential problems are detected and managed promptly.

Recommendations for Women with Congenital heart disease during pregnancy

For women with CHD who are planning to become pregnant, it is important to discuss their plans with their healthcare team. 

This team can provide personalized recommendations and management strategies to help ensure a successful and healthy pregnancy.

In general, Congenital heart disease in pregnancy should:

• Maintain good control of any underlying medical conditions, such as high blood pressure or diabetes.
• Take any necessary medications as prescribed by their healthcare team.
• Avoid activities or treatments that could strain the heart, such as excessive exercise or certain procedures.
• Attend all scheduled appointments with their healthcare team and promptly report any symptoms or concerns.
• With the right management and support, many women with CHD can successfully carry their pregnancy to term and have healthy outcomes for both mother and baby.

Labor and Birth

Labor and birth is the process of delivering a baby from the womb to the outside world. 

The process of labor and birth is typically divided into several stages, with the first stage starting when the mother begins to experience persistent contractions [1]. 

During this stage, the contractions become stronger, more regular, and more frequent. 

The cervical opening, softening, shortening, and thinning process will help the baby move into the birth canal [1].

The early signs of labor can be subtle and may not always be obvious, but some common signs include the thinning of the cervix (effacement) and the dilation of the cervix [3]. 

It is important to understand the signs of labor and the different stages of labor to be prepared for the birth process [2]. 

Pain management options, such as natural methods and medication, can also be considered during labor [2].

Conclusion

Pregnancy can be challenging for women with congenital heart disease, but with the right management and support, many can safely carry their pregnancy to term. 

Women with Congenital heart disease during pregnancy need to work closely with their healthcare team to develop a personalized management plan and to attend all scheduled appointments to ensure the best possible outcomes for both mother and baby.

Sources

[1] “You should see a cardiologist if you’re experiencing these symptoms: A feeling like your heart is racing very fast (often called heart palpitations). Feeling like you might faint. Shortness of breath that is worsening. Chest discomfort or bad indigestion that’s not going away. Swelling in the legs. Noticeable weight gain.”

https://health.clevelandclinic.org/when-to-see-a-cardiologist-for-heart-disease/ 

[2] “Examples of symptoms that suggest you may need a referral to a cardiologist include Chest discomfort Shortness of breath Swelling in your legs High blood pressure Abnormally fast or slow heart rate Dizziness or fainting Strong family history of premature heart disease or cardiac death Leg pain or ulcers resulting from blood vessel diseases”

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/when-to-see-a-cardiologist