Pregnancy and Heart Disease

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Pregnancy and childbirth is a wonderful experience. Regular check ups are part and parcel of the process, and maintaining the health of the mother and the baby are of prime importance.

There are times however when the mother may be suffering from some form of heart disease. The questions always arise then – Is it safe for me to get pregnant?, Will my baby be affected by my heart disease?, Will I have a healthy baby?

Asking these questions is completely natural, and getting answers for them is essential. This article has been broken down into numerous sections and pages, and describes in detail some of the commonly encountered heart conditions in pregnancy in India, and what the guidelines are regarding management.

 Normal changes in the heart in pregnancy

During pregnancy, the heart has to beat for 2 bodies, not one. For this reason, there are a number of changes that take place in order to achieve this task. Below is a brief list.

  1. Increase in heart rate – This change is seen after 20 weeks and keeps increasing till around 32 weeks. After delivery, the heart rate may remain high for a week or so.
  2. Increase in blood pressure –  In the initial stages of pregnancy, the blood pressure may decrease a little. This is because the blood vessels in the body dilate slightly in response to certain chemicals.
  3. Increase in blood volume – The amount of blood in the mother increases by around 40%. This is so that more nutrients and oxygen can reach the growing fetus.
  4. Increase in heart size – The size of the heart can increase by around 30%.
  5. Increase in the quantity of blood clotting factors – This phenomenon that occurs in pregnancy is mostly seen because the blood cells (platelets) become more sticky and many factors that cause blood clotting are released. This ‘sticky’ blood can increase the chance of the mother suffering from blood clots.

During delivery, the heart works twice as hard to pump blood to the fetus and the contracting uterus. The blood pressure also increases remarkably.

Diagnosing heart disease in pregnancy

As a pregnant woman, if you are concerned that you may have heart disease, or you already know this, then you can undergo certain tests that will determine the type of heart disease you have. These include –

  • Clinical examination by your doctor
  • Electrocardiography
  • Echocardiography
  • Exercise stress testing – This can be performed on a treadmill or an exercise bike.
  • Radiology testing – Tests such as a chest xray, CT scan and coronary angiography will only be performed if essential. The benefits of doing the procedure must be greater than the risks. For example, if a pregnant woman suffers from a pulmonary embolism (blood clot in the lung), then a CT scan may be necessary.

Just of note – performing an ultrasound scan to look at the fetus is completely safe and does not have any risks. If as a pregnant woman you are worried about your growing baby having heart disease, then performing screening tests between 18 and 22 weeks is the best time. Your doctor will guide you further regarding this.

Heart disease in pregnancy

There are a number of different heart conditions that prospective mothers may suffer from. For this reason, as Heart Sense we recommend that all women who wish to conceive get a full health check up including an echocardiogram. This will help pick up any obvious abnormalities that may need treatment before conception

There are many heart conditions that may be seen in women, and here we have talked about some of the commonly encountered ones in India. Click on the links below for further information.

1. Mitral stenosis – Click here

2. Atrial septal defect – Click here

3. Mitral regurgitation – Click here

4. Aortic stenosis/bicuspid aortic valve – Click here

5. Pulmonary hypertension – Click here

 

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