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Sep 22, 2011

Management of Heart Conditions During Pregnancy

New guidelines to help women with heart conditions have a healthy pregnancy and delivery.

With more than 42 million women in the United States living with heart disease, effective management of cardiovascular conditions during pregnancy is essential — now more than ever. As the prevalence of cardiovascular risk factors such as high blood pressure and obesity continue to increase, and many women are experiencing pregnancy at later ages, complications during pregnancy become more common. Fortunately, research from the last 20 years has helped experts from the European Society of Gynecology to compile comprehensive guidelines around the management of cardiovascular disease during pregnancy to improve outcomes for affected pregnant women and their children.

Recently published by the European Heart Journal, these guidelines help to outline the management of heart disease from the planning stages of pregnancy all the way to labor, delivery and follow-up. Most importantly, experts stress the need for individualized plans for pregnant women, beginning before pregnancy. Women with existing heart disease should talk with both their obstetrician and cardiologist together before pregnancy, and a risk assessment should be performed. Women healthy enough to carry a pregnancy should then work closely with this team of specialists to monitor their cardiovascular health throughout each trimester, with tests such as echocardiography and exercise testing. They should always be treated in specialized centers that are well-equipped to deal with any possible complications that may arise during pregnancy, particularly during labor and delivery. And lastly, experts stress the importance of future registries and studies to help further knowledge of heart disease during pregnancy and improve outcomes for mother and child.

Although these guidelines from the European Society of Gynecology may change over the years as new information becomes available to researchers, their creation will help standardize the treatment of women with heart disease during pregnancy. However, experts do stress that final medical decisions are always up to the responsible physicians and specialists caring for individual patients, as the cardiovascular risks and overall health of each woman is unique. 

Questions for You to Consider

  • How many women are affected by heart disease during pregnancy?
  • It is estimated that 0.2-4% of all pregnancies in western industrialized countries, such as the United States, are complicated by heart disease. Of these complications, high blood pressure and hypertensive disorders are the most common conditions that present during pregnancy, occurring in 6-8% of all pregnancies.
  • Can women without any history of heart disease develop cardiovascular complications during pregnancy?

  • Yes. The many changes that occur in the body during pregnancy can put extra stress on the heart, causing high blood pressure, and sometimes an irregular heartbeat, known as arrhythmia. Many of these conditions that develop during pregnancy go away in the time following delivery, although some may not.


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