Congenital Heart Disease In Pregnancy

If you were born with a cardiac abnormality and have had a successful operation to correct it, you’ll likely have some scarring of the heart. This may make you more susceptible to infections or an irregular heartbeat. Approximately 8 out of every 1,000 babies are born with some sort of heart defect. This is sometimes referred to as congenital heart disease or congenital heart defect. What should you take into consideration regarding congenital heart disease in pregnancy?

Congenital Heart Disease in Pregnancy: Is It Safe?

Although it is possible to have a healthy pregnancy if you have heart disease, pregnancy puts your heart under a lot of strain, which might cause issues. Therefore, consult your doctor before getting pregnant or as soon as you find out you are pregnant.

When planning a pregnancy, it’s important to consult your cardiologist if you were born with a heart condition. If you were treated for congenital heart disease as a baby/child, it’s possible that you haven’t seen a heart specialist in a long time. If you don’t currently have a cardiologist, ask your doctor to recommend one.

Your doctor can discuss the following with you:

Congenital Heart Disease in Pregnancy: Effect on Baby

Your congenital heart disease may have an impact on your unborn child. Babies may be born prematurely. Your baby may be smaller if your heart does not pump as effectively as it should, delivering less oxygen and nutrients to the placenta and your developing unborn child.

But not to worry, you will be offered routine scans throughout your pregnancy to make sure your unborn child is developing normally and healthily.

There is a possibility that your baby could inherit the condition from you depending on the type of congenital heart disease you have. For instance, there is a 1 in 2 chance that your baby could inherit Marfan sSndrome. 

Many, but not all, conditions in an unborn baby can be detected during pregnancy. The future management of your pregnancy and care of your baby will be discussed with you. A specialist in children’s heart conditions (cardiac pediatrician) will advise you on the options available once your baby is born. You need to learn as much as you can about your condition so your baby can receive special care if necessary when they are born.

Prenatal Care Plan 

Your cardiologist, together with other physicians (like your OB), will give you a personalized prenatal care plan, and the type of treatment you receive will depend on your condition. In other words, a multidisciplinary approach for patients with congenital heart disease is crucial.

This might necessitate a modification in the medications you take. For instance, ace inhibitors (a class of drugs used to treat heart failure) are not advised during pregnancy. Your doctor will go over this with you. Do not stop taking any medications without first consulting your doctor.

Low-impact activity, like swimming and walking, is typically an excellent option to keep you in shape during your pregnancy. However, always speak to your midwife or doctor before beginning any new exercise program.

Congenital Heart Disease in Pregnancy: Labor and Delivery

Your healthcare team should include a cardiologist with experience treating congenital heart disease throughout pregnancy. You may be advised to give birth in a hospital. Discuss your options for where to give birth with your medical team.

It’s usually best to wait for spontaneous labor (labor that starts naturally), unless the baby needs to be delivered early because you’re unwell or the baby is not growing normally. Always seek the guidance of your primary doctor. Depending on the type and severity of heart disease, induction may not be recommended due to the effect medications used may have on the heart.

Your healthcare team will discuss all of your options with you. However, it may be advised that you have pain-free labor, which means that you should have an epidural, and your doctor may use forceps or a vacuum delivery (ventouse) to assist you. This prevents additional strain on you and the baby. 

If you have congenital heart disease, you will not automatically be advised to have a cesarean section; this will depend on the type and severity of your case. 

Learn more about Congenital Heart Disease here.