Congenital Heart Disease and Managing High-Risk Pregnancy

When most girls take into consideration coronary heart illness throughout being pregnant, they might take into consideration hypertension or different situations that develop throughout being pregnant. But for ladies with congenital coronary heart illness (cardiac illness that’s current from delivery all through their lives), being pregnant itself can current potential severe unwanted side effects.

Cardiac Complications

Adult congenital coronary heart illness (ACHD) describes numerous totally different issues affecting the guts. It is the commonest sort of delivery defect, and whereas some issues may be corrected, they might nonetheless require medical supervision all through an individual’s life particularly throughout being pregnant.

“It’s estimated there are more than one million adults with congenital heart disease in the United States,” says Yuli Kim, MD, director of the Philadelphia Adult Congenital Heart Center. “More and more children with congenital heart disease are reaching reproductive age, and need high-risk obstetrical care in collaboration with specialized cardiac care.”

Women with congenital coronary heart illness are seen on the Philadelphia Adult Congenital Heart Center, a joint effort between Penn Medicine and the Children’s Hospital of Philadelphia (CHOP). Together, they serve the distinctive well being care wants of those sufferers. The middle is comprised of specialists in cardiology, cardiovascular surgical procedure, non-invasive imaging, genetics and reproductive providers that take care of sufferers with congenital coronary heart illness. The middle additionally presents high-risk obstetrical care by way of Penn’s Maternal Fetal Medicine Program.

High-Risk Care

“Pre-conception (or pre-pregnancy) care is recommended for any woman who plans to get pregnant,” says Lisa Levine, MD, MSCE, director of the Penn Medicine Pregnancy and Heart Disease Program. Getting to a wholesome weight previous to conception and eliminating harmful exposures reminiscent of smoking are emphasised to all ladies. “But a woman with cardiac disease needs counseling beyond what a woman without cardiac disease may need.”

At Penn, ladies with a historical past of congenital coronary heart illness obtain pre-conception counseling from a multi-disciplinary workforce of cardiologists and maternal fetal medication specialists and geneticists. A maternal fetal medication specialist is an obstetrician who has obtained further coaching within the analysis and care of high-risk pregnancies.

A geneticist can assist you establish in case you are at an elevated threat for having a baby with a congenital coronary heart defect. The specialist might suggest a fetal echocardiogram throughout being pregnant to judge the fetal coronary heart. In some circumstances a particular genetic check could also be advisable to find out whether or not the mom and/or fetus has a genetic reason for congenital coronary heart illness.

“It’s important we work together to create a plan and make recommendations to women with cardiac disease,” says Dr. Kim. “Together, we can talk about possible risks, and how to manage cardiac disease during pregnancy.”

Ensuring a Healthy Pregnancy and Delivery

“Congenital heart disease can increase the risk of complications in the pregnancy for both mom and baby. In some forms of structural heart disease, there is a risk of heart failure or other complications that may be caused due to the body’s changes and adaptations to pregnancy,” says Dr. Levine.

With cautious planning and prenatal care, the dangers of opposed outcomes seem like very small. In reality, most girls with a repaired congenital coronary heart defect can get pleasure from full-term deliveries and not often want a cesarean part attributable to their coronary heart illness.

“Because there are so many variables involved with both a woman’s cardiac condition, pregnancy and delivery,” provides Dr. Levine, “it’s important for women to get their pre-conception and prenatal care from a multi-disciplinary team of experts experienced in managing high-risk pregnancies and cardiac conditions such as the team we have at Penn.”

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