Can a woman get pregnant if she has congenital heart disease? & bull; hello healthy

Advances in treatment in recent decades have made a real difference to babies born with heart defects. About 85-90% of children born with congenital heart defects today can survive into adulthood.

If you are a member of this newer generation of adults, you may have been wondering about safety during pregnancy and childbirth.

For many women who are born with heart defects, pregnancy is as safe as women with a normal heart. For some women with severe congenital heart defects, pregnancy may carry a high risk, for both mother and baby. For women in this group, sometimes it is possible to give birth if specifically coordinated and cared for by a cardiologist and obstetrician.

Important notes regarding pregnancy and congenital heart defects

Don't believe it if someone says a woman with heart defects "can't get pregnant". This statement requires clarification from the medical team. Some women may interpret statements like this as a sign that they cannot get pregnant, when, in fact, they prefer not to get pregnant (because of the risk to their or the baby's health).

Likewise, you may have heard that you "can't get pregnant" while taking medications like Coumadin (warfarin). Coumadin will not prevent pregnancy, but you should not take it while pregnant because it can cause serious side effects to the developing fetus, such as birth defects or miscarriage. Before becoming pregnant, it is important to determine if any medication changes need to be made to protect you and / or the baby.

In addition, if you or your partner has a congenital heart defect — or there is a family history of congenital heart defects — the risk of your child being affected by heart disease increases. The specific risks vary depending on the form of congenital heart defect you have. It is important to discuss this risk with a team of nurses and genetic counselors.

If you are a woman with a congenital heart defect hoping to become pregnant, carefully examine your options with the guidance of a healthcare team experienced with women with congenital heart defects.

Medical team during pregnancy

If you were born with a heart defect, you may have become accustomed to taking care of your own health. Whether you have experience caring for yourself or are just starting to learn that you have a heart defect, you should try to find out as much as possible about your condition. If your heart health has been handled up to now by the family, ask, if possible, about any medications you had as a child and try to keep your medical records from any hospital where you were treated. Carry with you the information on the schedule of visits related to your pregnancy.

Remember: Detailed knowledge of your heart condition will allow your healthcare provider to work with you to provide as much flexibility as possible. Being critical in assessing pregnancy choices and ensuring the safety of you and the baby will compile your medical team. If you have significant congenital heart disease, you will likely have a high-risk obstetrician and / or perinatologist (obstetrician who specializes in managing higher-risk pregnancies) who will be part of your nursing team. They will work closely with a cardiologist to guide you along your questions about pregnancy. They will be able to advise you about any health risks and babies.

Ideally, conversations about pregnancy will take a long time before becoming pregnant. If not, involve your obstetrician and cardiologist as much as possible. If you are already pregnant, your cardiologist and obstetrician can advise you about any surgery or interventional treatment that may be important for your heart during or after pregnancy, as well as any medications (medical therapy) you may need to take or even stop for safety reasons. You will most likely be referred to a perinatologist.

A team-based approach with you, perinatologist, obstetrician, and cardiologist will help determine how to keep you and your baby healthy during pregnancy, as well as the best method for delivery, whether natural or by caesarean section.

Risk of pregnancy in women with congenital heart defects

Although many women with congenital heart defects are able to give birth successfully, careful risk assessment is essential. Heart disease is the number 1 cause of death in women worldwide, and women with congenital heart disease in some cases will be less able to tolerate the cardiovascular changes that accompany pregnancy and birth.

Currently, below are examples of congenital heart defects that do not significantly increase the risk to the mother (individual cases vary):

• Atrial septal or ventricular septum (without other abnormalities)
• Aortic coarctions - after treatment
• Tetralogy fallot - after surgery

Examples of high-risk forms of congenital heart disease in pregnancy include:

• Pulmonary hypertension
• Eisenmenger syndrome
• Severe aortic stenosis or other valve abnormalities
• Single ventricular heart disease (in which the heart has only one chamber capable of pumping blood out of the heart, rather than two) or other forms of cyanotic heart disease

A cardiologist can advise you on whether your congenital heart defect carries a high, moderate, or low risk — and the best way to protect your health and that of your baby.

Questions to the doctor about pregnancy and congenital heart disease

The questions below can help you talk to your doctor. Print or record these questions and take them to visits. Taking notes can help you remember the doctor's response when you get home.

• As a woman with congenital heart disease, is pregnancy safe for me?
• As a man or woman with congenital heart disease, is my child more likely to have congenital heart disease?
• If pregnancy is not recommended, what are my contraceptive options?
• Are some forms of contraception safer than others?

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