Women with a congenital heart defect (CHD) who, after preconception counseling, are able to have a safe or low-risk pregnancy, can take additional steps to plan for a healthy pregnancy.
Your Medical Care Team:
Be sure your medical care team has knowledge and experience in treating pregnant women with a CHD. The specific members of this team may differ depending on where you live and what kind of heart condition you have.
Genetic Counselor: Reviews your medical history and may perform testing to discuss the baby's risk for having a CHD. In general, a baby whose mother or father has a CHD has a small increased chance (about 5%) of being born with a CHD, too.
Anesthesiologist: Can talk to you about anesthesia options for labor and delivery. Most women with a CHD can have an epidural during labor and delivery. Vaginal delivery is usually preferred over a caesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.
Social Worker: Can help counsel you and your partner on how to handle the stress of managing both your cardiac and pregnancy health.
During Your Pregnancy:
It is very important to maintain regular care with your obstetrician and congenital cardiologist throughout your pregnancy. Although most women will do well and have healthy pregnancies, women with a CHD do have a higher risk for pregnancy complications, including arrhythmias or irregular heartbeats and premature birth.
Your congenital cardiologist will determine how often you will require cardiac care during pregnancy. Most women with a CHD see their congenital cardiologist once each trimester, but sometimes more frequent appointments are needed. Your doctor will also determine whether you need cardiac testing during your pregnancy. Most women with a CHD receive an echocardiogram (ultrasound of the heart) early in pregnancy and in the last trimester.
As with any pregnant woman, there are ways you can help reduce health risks to your baby before and during pregnancy:
Take a daily prenatal vitamin that includes folate.
Avoid smoking, alcohol and other drugs (other than medications prescribed by your doctor).
Eat a healthy diet.
Exercise.
Get enough rest.
Labor & Delivery:
At some point, you will discuss the type of delivery—vaginal or cesarean section—with your obstetrician. Typically, a vaginal delivery is preferred over a cesarean section for most women with a CHD. There may be some special monitoring and accommodations made during your labor and delivery, but all medical care is geared toward the safety of you and your baby.
Regardless of the type of delivery, an anesthesiologist is usually involved to assist with pain control. Most women with a CHD can have an epidural during labor and delivery, but some types of medicine for pain control can affect the heart rate and blood pressure—why meeting with an anesthesiologist before delivery is important!
Your Baby's Health:
Your baby is at increased risk of being born with a CHD if you or your baby's father have a CHD. Preconception counseling can also assess your baby's CHD risk.
Once you're expecting, your doctor will do a special ultrasound of your baby's heart, called a fetal echocardiogram, to see if your baby has any major structural issues to the heart.
Additional Information from HealthyChildren.org:
Additional information regarding congenital heart defects and lifelong cardiac care is available at the Congenital Heart Public Health Consortium (CHPHC) website, www.chphc.org. The CHPHC is housed at the American Academy of Pediatrics through a grant from the Centers for Disease Control and Prevention in an effort to utilize public health principles to affect change for those whose lives are impacted by a CHD. Organizational members of the Consortium represent the voice of providers, patients, families, clinicians and researchers.