Heart disease and pregnancyHHeart disease and pregnancyHeart disease and pregnancyEnglishPregnancyAdult (19+)BodyReproductive systemConditions and diseasesPrenatal Adult (19+)NA2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSCRory Windrim, MB, MSc, FRCSC12.000000000000043.00000000000001055.00000000000Flat ContentHealth A-Z<p>Learn about the effects of various types of maternal heart disease on pregnancy. Treatment of heart disease during pregnancy is also discussed.</p><p>Pregnancy has a profound effect in women who have underlying heart disease. Much of the increase in the output of the heart occurs during early pregnancy. As a result, a pregnant woman with heart disease may have additional cardiovascular problems by the middle of her pregnancy. The outcome for a pregnant mother with heart disease depends on the capacity of her heart, whether there are other complications during pregnancy, and what type of medical care she receives. For some women, bed rest may be required throughout pregnancy. </p><h2>Key points</h2> <ul><li>The different types of heart disease are categorized into three groups according to the risk of death that they pose to the mother in pregnancy.</li> <li>Women with heart disease may need to be followed by a multidisciplinary team that specializes in heart disease in pregnancy.</li> <li>If you are pregnant and you have mild heart disease, avoid people who have respiratory infections, get a flu shot and do not smoke.</li> <li>Babies of mothers with heart disease may inherit congenital heart problems.</li></ul>
Cardiopathie et grossesseCCardiopathie et grossesseHeart disease and pregnancyFrenchPregnancyAdult (19+)BodyReproductive systemConditions and diseasesPrenatal Adult (19+)NA2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSC Rory Windrim, MB, MSc, FRCSC12.000000000000043.00000000000001055.00000000000Flat ContentHealth A-Z<p>Apprenez-en davantage sur les effets que différents types de cardiopathies maternelles peuvent avoir sur la grossesse. Cette section fournit également de l’information sur le traitement des cardiopathies pendant la grossesse.</p><p>Chez une femme atteinte d’une cardiopathie sous-jacente, les effets de la grossesse sont graves. Pendant la grossesse, le volume sanguin de la mère augmente considérablement pour combler les besoins du bébé en développement. Par conséquent, le cœur doit s’activer bien plus pour pomper le sang. C’est au stade précoce de la grossesse que l’activité cardiaque augmente le plus. Par conséquent, une femme enceinte souffrant de cardiopathie peut avoir d’autres problèmes cardiovasculaires au milieu de sa grossesse. L’aboutissement de la grossesse chez une femme souffrant d’une affection cardiaque dépend de la capacité de son cœur, de l’éventualité que d’autres complications se déclarent en cours de grossesse et des soins médicaux qu’elle reçoit. Certaines femmes doivent s’aliter tout au long de leur grossesse.<h2>À retenir</h2> <ul><li>Les différents types de maladies cardiaques sont divisés en trois catégories selon le risque de décès qu’ils posent à la mère au cours de la grossesse.</li> <li>Les femmes atteintes d’une maladie cardiaque peuvent avoir besoin d’être suivies par une équipe multidisciplinaire qui se spécialise dans les maladies cardiaques lors de la grossesse.</li> <li>Si vous êtes enceinte et que vous êtes atteinte d’une maladie cardiaque légère, évitez les personnes atteintes d’infections respiratoires, obtenez le vaccin contre la grippe et ne fumez pas.</li> <li>Les bébés de mères atteintes d’une maladie cardiaque peuvent hériter de problèmes cardiaques congénitaux. </li></ul>

 

 

Heart disease and pregnancy364.000000000000Heart disease and pregnancyHeart disease and pregnancyHEnglishPregnancyAdult (19+)BodyReproductive systemConditions and diseasesPrenatal Adult (19+)NA2009-09-11T04:00:00ZNicolette Caccia, MEd, MD, FRCSCRory Windrim, MB, MSc, FRCSC12.000000000000043.00000000000001055.00000000000Flat ContentHealth A-Z<p>Learn about the effects of various types of maternal heart disease on pregnancy. Treatment of heart disease during pregnancy is also discussed.</p><p>Pregnancy has a profound effect in women who have underlying heart disease. Much of the increase in the output of the heart occurs during early pregnancy. As a result, a pregnant woman with heart disease may have additional cardiovascular problems by the middle of her pregnancy. The outcome for a pregnant mother with heart disease depends on the capacity of her heart, whether there are other complications during pregnancy, and what type of medical care she receives. For some women, bed rest may be required throughout pregnancy. </p><h2>Key points</h2> <ul><li>The different types of heart disease are categorized into three groups according to the risk of death that they pose to the mother in pregnancy.</li> <li>Women with heart disease may need to be followed by a multidisciplinary team that specializes in heart disease in pregnancy.</li> <li>If you are pregnant and you have mild heart disease, avoid people who have respiratory infections, get a flu shot and do not smoke.</li> <li>Babies of mothers with heart disease may inherit congenital heart problems.</li></ul><p>Heart disease in the mother complicates about 1% of all pregnancies. Congenital heart lesions make up about half of all cases of heart disease in pregnant mothers. Although the management of this condition has improved over the years and there are new surgical techniques, heart disease remains a major cause of maternal death throughout the world. </p> <p>During pregnancy, the volume of blood in the mother’s body increases dramatically to meet the needs of the growing baby. As a result, the heart has to work that much harder to pump blood through the mother’s body. </p> <h2>Types of heart disease</h2> <p>Before discussing the different types of heart disease, it is helpful to try to understand a bit about the structure of the cardiovascular system. The cardiovascular system consists of the heart and blood vessels called veins and arteries. The heart pumps blood throughout the body. It contains two upper chambers called atria and two lower chambers called ventricles. Veins bring blood to the vena cava and then to the heart. The aorta brings blood away from the heart to the arteries, where the blood is distributed to other areas of the body. </p> <p>There are many different types of heart disease, and they can be categorized into three groups according to the risk of death that they pose to the mother in pregnancy. </p> <h3>Group 1: Heart disease with 1% or lower risk to the mother in pregnancy</h3> <ul> <li>atrial septal defects: a hole between the two upper, or receiving, chambers of the heart, called the atria </li> <li>ventricular septal defects: a hole between the two lower, or pumping, chambers of the heart, called the ventricles </li> <li>patent ductus arteriosus: a condition where an important fetal structure in the heart did not close properly after birth </li> <li>tricuspid disease: a narrowing of the flaps between the right atrium and right ventricle of the heart </li> <li>tetralogy of Fallot, corrected: a condition where there is a hole between the ventricles of the heart, there are obstructions between the right ventricle and the lungs, the aorta lies right over the hole between the ventricles, and the right ventricle tissue becomes thickened; in this case, the condition has already been corrected with surgery </li> <li>bioprosthetic valve: an artificial heart valve that has been implanted to replace a defective valve </li> <li>mitral stenosis, New York Heart Association class I or II: a mild to moderate narrowing of the valve between the left atrium and left ventricle of the heart </li></ul> <h3>Group 2: Heart disease with 5% to 15% risk to the mother in pregnancy</h3> <ul> <li>mitral stenosis, New York Heart Association class III or IV: a more serious narrowing of the valve between the left atrium and left ventricle of the heart </li> <li>aortic stenosis: a narrowing of the valve leading from the left ventricle to the aorta </li> <li>aortic coarctation without valve involvement: a narrowing of the aorta somewhere along its length </li> <li>tetralogy of Fallot, uncorrected: tetralogy of Fallot which was not corrected before pregnancy </li> <li>previous heart attack </li> <li>Marfan syndrome, normal aorta: a connective tissue disorder that affects the heart, blood vessels, skeleton, lungs, and eyes </li></ul> <h3>Group 3: Heart disease with 25% to 50% risk to the mother in pregnancy</h3> <ul> <li>pulmonary hypertension: high blood pressure in the arteries that move blood from the heart to the lungs </li> <li>aortic coarctation with valve involvement </li> <li>Marfan syndrome with valve involvement </li></ul> <h2>Treatment of heart disease during pregnancy</h2> <p>Women with heart disease may need to be followed by a multidisciplinary team that specializes in heart disease in pregnancy. Some heart diseases need to be treated with specific drugs. </p> <p>Women who have had a valve replacement usually require a drug called an anticoagulant, such as heparin, throughout pregnancy until just before delivery, and then the drug will need to be restarted shortly after delivery. Note that another anticoagulant, <a href="/Article?contentid=265&language=English">warfarin​</a>, is thought to be a teratogen. </p> <p>Women with mitral stenosis may need a drug called a beta-blocker to slow the heart rate response to activity and anxiety.</p> <p>Women who have had a heart attack may need an array of drugs such as nitrates, calcium channel blockers, or beta-blockers.</p> <p>Women with mild heart disease generally go through pregnancy without any major problems. To be on the safe side, special attention should be given toward preventing and recognizing the early signs of heart failure: </p> <ul> <li>shortness of breath </li> <li>persistent wheezing, sometimes with a cough </li> <li>fatigue </li> <li>difficulty carrying out normal activities </li> <li>increased heart rate and palpitations </li></ul> <p>If you are pregnant and you have mild heart disease, you should make sure to avoid people who have respiratory infections, as these infections can lead to heart failure. Consider getting a flu shot and refrain from smoking. </p> <p>If you have serious heart disease and are pregnant, you will need to carefully consider the risks and cooperate fully with your doctor’s plan of care for you. If you are early into your pregnancy, you may want to consider ending the pregnancy through therapeutic abortion. If you choose to continue the pregnancy, prolonged hospitalization and bed rest will usually be required. </p> <h2>Labour and delivery in women with heart disease</h2> <p>In general, women with mild heart disease should attempt childbirth vaginally unless there is another complication that requires a caesarean section. Despite the physical effort required for vaginal birth, the outcomes are better and the risks for the mother are lower when compared with caesarean section. Pain relief during childbirth is very important, and may involve medications called intravenous analgesics or epidurals. You will be closely monitored during labour and delivery. </p> <p>Likewise, pregnant women with serious heart disease should still try to deliver vaginally, if their caregiver recommends a vaginal birth. Very ill women do not tolerate major surgical procedures such as caesarean section very well. If possible, the delivery should be done in a hospital that has extensive experience with complicated cardiac disease. </p> <h2>Effects of maternal heart disease on the unborn baby</h2> <p>Babies of mothers with heart disease may inherit congenital heart problems. Congenital heart disease in the unborn baby can sometimes be diagnosed during pregnancy using a procedure called a fetal echocardiogram. Sometimes congenital heart disease can be treated with surgery shortly after birth. </p>https://assets.aboutkidshealth.ca/AKHAssets/heart_disease_and_pregnancy.jpgHeart disease and pregnancy

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