Can a Woman with a Congenital Heart Defect Still Have a Baby?
The short answer to this question is, maybe. It really depends on what kind of congenital heart defect (CHD) the woman has. If it is one of the more complex defects and has certain symptoms present, the answer may be no. If it is a less complex defect, the answer may be yes. More than likely, for a woman who has a more complex heart condition, the pregnancy would be considered high risk.
At one time, it was believed that it was never a good idea for a woman with a congenital heart defect to get pregnant. Now, however, with advances in medical technology and increased studies with adults who have congenital heart defects, that is no longer the case.
According to Dr. Carole Warnes, a cardiologist from the Mayo Clinic who specializes in adults with CHD, "most women, even with complex anomalies can have successful pregnancies."
Dr. Warnes also says that "a growing medical understanding of how to manage heart conditions during pregnancy and delivery has led more cardiologists to explain the risks but give women the choice to have babies if they choose."
What Are the Risks?
In a normal pregnancy, the volume of plasma produced is raised by 50% in the second trimester. The mother's blood pressure may decline and the heart rate raises by 10-20%. This is why it is riskier for a woman with a heart defect, especially a more complex heart defect, to be pregnant.
Some of those risks include:
- Blood clots
- Heart Failure
- The baby might be born with a heart condition (a fetal echocardiogram can be done in the 18th week of pregnancy to determine this)
- Certain heart medications can pose a risk to the developing fetus
- A c-section is riskier than a vaginal delivery because there is more blood loss
There are some instances where it is highly recommended that a woman with the following conditions should not get pregnant:
- pulmonary hypertension - high blood pressure in the arteries leading from the heart to the lungs
- pulmonary vascular disease such as Eisenmenger’s - when there is a hole between the two pumping chambers (ventricles)
- women who are cyanotic - a bluish tint to the skin and/or fingernails and lips due to lack of oxygen
In these instances, there is a high risk of death to the mother and/or the baby.
Women born with complex CHD who have had corrective surgeries such as Fontan, Mustard, and Rastelli, are a relatively new group of women. But data has proven that women who have had these procedures and who are clinically stable, seem to do well through pregnancy. However, it is still good for them to be closely monitored.
Consult Your Cardiologist
It is important that if you do have a congenital heart defect, that you discuss having a baby with your cardiologist before getting pregnant. Preferably, you should see a cardiologist who specializes in adults with congenital heart defects. Most likely, especially if your pregnancy would be considered high risk, you will have to be closely monitored.
- Adult Congenital Heart Association > For Members > ACHD Clinic Directory
Where to find cardiologists who specialize in adults with congenital heart defects.
It is also important to note that for women with CHD, depending on their condition, they may have to avoid certain types of birth control, such as estrogen-containing birth control. These may increase the risk of blood clots. An example of estrogen-containing birth control would the the pill. Also, intrauterine devices (IUD) may have to be avoided due to increased risk of infection. It is important for a womam with a congenital heart defect to talk to their cardiologist about contraception that is safe for them.
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