Heart Problems and Pregnancy....8

Heart Problems and Pregnancy....8

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14... Heart disorders during Pregnancy
Most women who have heart disorders—including heart valve disorders (such as mitral valve prolapse) and some birth defects of the heart—can safely give birth to healthy children, without any permanent ill effects on heart function or life span. However, women who have moderate or severe heart failure before pregnancy are at considerable risk of problems. Before becoming pregnant, such women should talk to their doctor to make sure their disorder is being treated as effectively as possible.
For women with some types of heart disorders, pregnancy is inadvisable because it greatly increases the risk of death. These disorders include
  • Pulmonary Hypertension (high blood pressure in the arteries of the lungs)
  • Certain heart birth defects, including Eisenmenger syndrome (a complication of some heart defects) and sometimes coarctation of arorta
  • Sometimes Marfen syndrom (a hereditary connective tissue disorder)
  • Severe aortic stenosis (narrowing of opening of the aortic heart valve)
  • Heart damage  that occurred in a previous pregnancy
If women who have one of these disorders become pregnant, doctors advise them to terminate the pregnancy as early as possible.
Pregnancy requires the heart to work harder. Consequently, pregnancy may worsen a heart disorder or cause a heart disorder to produce symptoms for the first time. Usually, the risk of death (to the woman or fetus) is increased only when a heart disorder was severe before the woman became pregnant. However, depending on the type and severity of the heart disorder, serious complications may develop in more than 10% of women. These complications include accumulation of fluid in the lungs (pulmonary edema), an abnormal heart rhythm, and stroke.
The risk of problems increases throughout pregnancy as demands on the heart increase. Pregnant women with a heart disorder may become unusually tired and may need to limit their activities. Rarely, women with a severe heart disorder are advised to have an abortion early in pregnancy. Risk is also increased during labor and delivery. After delivery, women with a severe heart disorder may not be out of danger for 6 months, depending on the type of heart disorder.

A heart disorder in pregnant women may affect the fetus. The fetus may be born prematurely. Women with certain birth defects of the heart are more likely to have children with similar birth defects. Ultrasonography can detect some of these defects before the fetus is born. If a severe heart disorder in a pregnant woman suddenly worsens, the fetus may die.

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