Heart Disease and Pregnancy
Often young women with cardiovascular
disease are told that they should not become pregnant, when in fact;
they may be able to undergo a safe pregnancy successful for both mother
and baby. At Northwestern Memorial Hospital, the Heart Disease and
Pregnancy Program has nearly 20 years experience managing all forms of
heart disease during pregnancy.
The Heart Disease and Pregnancy Program takes a multidisciplinary approach involving specialists from Maternal-Fetal Medicine (high-risk Obstetrics), Anesthesia, Obstetrics, Genetics, and other medical subspecialties to provide comprehensive care for pregnant women with heart disease. Women that will benefit from this program include women born with heart disease, those that acquire heart disease prior to their childbearing years, and/or those that develop heart disease during pregnancy. Over 1500 women have been followed in this program with all types of heart disease.
Pregnancy places unique demands on the mother's circulatory system,
which may cause problems if there is underlying heart disease. Heart
problems during pregnancy may develop because of the cardiac changes
associated with pregnancy or the pregnancy itself may be affected by
the underlying heart problem. Therefore, it is important that the women
with heart disease have a complete preconception evaluation prior to
becoming pregnant. This evaluation can be life saving and will
certainly help to promote a successful pregnancy outcome. The Heart
Disease and Pregnancy Program has developed strategies that are
specific for different types of heart disease.
During pregnancy, there
are changes that occur in the mother's circulatory system that are
expected and normal. Because a mother's circulation is asked to provide
additional blood to the uterus and the placenta, her blood volume
increases. The plasma (fluid in the blood) volume increases faster than
the blood cells increase resulting in an anemia (lower than normal number of red blood cells) during pregnancy.
Anemia can increase demands on the heart. The plasma volume increase
begins early in pregnancy and reaches peak effects between 24 and 26
weeks. This plasma level change, when compared to the non-pregnant
state, is increased by approximately 50 percent. Later in pregnancy,
the heart rate increases to promote circulation of blood to the uterus.
The highest heart rates for the mother are in the last trimester. The
heart rates may increase between 10 and 20 percent but the woman may
not be aware of this change. The total cardiac output (volume of blood
pumped out of the heart with each beat) increases in mid-pregnancy by
up to 50 percent. In addition, it is normal during pregnancy for the
blood vessels to dilate and the blood pressure to fall.
The purpose of
the Heart Disease and Pregnancy Program is to provide specialized,
appropriate care for the pregnant woman with heart disease. The goal is
successful outcome for both mother and baby. Marla A. Mendelson,
MD is the founder and director of the Heart Disease and Pregnancy
Program. Known for her research on heart disease during pregnancy,
heart disease in women, and adult congenital heart disease, Dr.
Mendelson understands that it is imperative that all women of
childbearing age who have heart disease and are contemplating pregnancy
to receive a complete preconception evaluation prior to becoming
pregnant.
Contact
Heart Disease and Pregnancy Program
(866) 662-8467 (toll free)
Heart Disease and Pregnancy Program
Preconception Evaluation
Congenital Heart Disease and Pregnancy
Cardiac Diseases and Pregnancy
Cardiac Signs and Symptoms During Pregnancy
Medical Management of Heart Disease and Pregnancy
Diagnostic Testing Durning Pregnancy
Labor and Delivery with Heart Disease
Review Date: 08/06
