MANAGING HEART CONDITIONS DURING PREGNANCY

What is the impact of unmanaged heart disease in pregnant women?

Known structural or congenital heart disease, hypertension are conditions that need to be monitored closely to prevent severe complications that can be detrimental to the mother and her baby.

During the first trimester, there are physiological changes increasing blood flow and output from the heart. As a result, the heart pumps more blood. By monitoring blood pressure changes during prenatal appointments, your healthcare provider may closely monitor the health of you and your baby and prevent a sudden drop in blood pressure. Due to these physiological changes during pregnancy, if you have underlying heart disease, this places additional strain on the heart and may lead to symptoms. This can also affect the development and growth of your baby.

If you already have an existing heart condition, you must take the necessary precautions to ensure the safety of you and your baby. Dr Muller will discuss your treatment options during a prenatal appointment to prevent severe illness. This is managed between your obstetrician and cardiologist.

Severe heart conditions that need to be assessed regularly are:

• Hypertension during pregnancy. This needs close monitoring to ensure healthy mom and baby.
• Arrhythmia normally occurs during pregnancy which may be a sign of an underlying cardiac condition even without the presence of a structural defect.
• A heart murmur, or sound that occurs during a heartbeat, is common in over eighty per cent of pregnant women. A heart murmur occurs when a high flow of blood travels throughout the heart. This, however, may also be due to a valvular problem. A thorough cardiac exam is needed to differentiate the two.
• Cardiomyopathy during the last month of pregnancy that lasts five months after the birth of your baby is known as peripartum cardiomyopathy. Usually, mild to severe symptoms may occur. Symptoms include lethargy, palpitations, swollen ankles and neck veins, as well as a drop in blood pressure.
• Marfan syndrome is a disorder that targets the connective tissue of different internal structures such as blood vessels, the eyes and the heart. Pregnancy places great stress on the blood vessels and heart. As a result, a pregnant woman with Marfan syndrome is at great risk of a rupture in the aorta that can become life-threatening for both mother and her baby. Echocardiograms should be done to monitor the growth rate of the aorta.
• Valvular heart disease may occur during pregnancy. Of particular concern is mitral stenosis. This is a narrowing of the left-sided heart valve, which may cause symptoms during pregnancy. This requires a multidisciplinary team approach to ensure a healthy pregnancy.

What is the outcome concerning treatment?

If you are currently on heart medication, Dr Muller will review this along with the dosage and regulate its usage accordingly. Regular prenatal consultations are scheduled whereby an echocardiogram and electrocardiogram are carried out to assess the health of your heart.

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