Can Women Get Pregnant If They Have Congenital Heart Disease?

Progress in treatment in the past decade has made real changes in babies born with heart disorders. About 85-90% of children born with congenital heart defects can now survive to adulthood.

If you are a member of this newer generation of adults, you might have wondered about safety during pregnancy and childbirth.

For many women who are born with heart problems, pregnancy is as safe as a woman with a normal heart. For some women with severe congenital heart defects, pregnancy may carry a high risk, both for mother and baby. For women in this group, sometimes it can be given birth if coordinated and treated specifically with cardiologists and obstetricians.

Important notes regarding pregnancy and congenital heart defects

Don't believe if anyone says women with heart disorders "can't get pregnant". This statement requires clarification from the medical team. Some women may translate statements like this as a sign that they cannot get pregnant, even though, in fact, they are more than not allowed to get pregnant (because of their health or baby's risk).

Likewise with you, who may have heard that you "cannot get pregnant" when you are taking medications such as Coumadin (warfarin). Coumadin will not prevent pregnancy, but you should not take the drug during pregnancy because it can cause serious adverse effects on the developing fetus, such as birth defects or miscarriages. Before becoming pregnant, it is important to determine whether there are any medication changes that need to be made to protect you and/or the baby.

In addition, if you or your partner has a congenital heart disorder - or there is a history of congenital heart abnormalities in the family - the risk of your child may be affected by increased heart disease. Special risks vary depending on the form of congenital heart disease that you experience. It is important to discuss this risk with a team of nurses and genetic counselors.

If you are a woman with a congenital heart disorder who hopes to get pregnant, carefully review your choices with a guide to the health care team who is experienced with women with congenital heart defects.

The medical team during pregnancy

If you are born with a heart disorder, you may be used to maintaining your own health. Whether you are experienced in caring for yourself or are just starting to learn that you have heart problems, you should try to find as much as you can about your condition. If your heart health is treated until now by the family, ask, if possible, about whatever treatment you are taking in childhood and try to keep your medical records from any hospital where you are treated. Bring information with you to the schedule of visits related to your pregnancy.

Remember: Detailed knowledge of your heart condition will allow health care providers to work with you to make the allowance as much as possible. Critical in assessing pregnancy choices and ensuring your and your baby's safety will compile your medical team. If you have significant congenital heart disease, you will likely have a high-risk obstetrician and perinatologist (an obstetrician who is expert in handling higher-risk pregnancies) who will be part of your nursing team. They will work with cardiologists to guide you along with questions about pregnancy. They will be able to advise you on any health risks and babies.

Ideally, conversations about pregnancy will take a long time before getting pregnant. If not, involve your obstetrician and cardiologist as much as possible. If you are pregnant, a cardiologist and obstetrician can advise you on any surgery or intervention treatment that may be important to your heart during or after pregnancy, as well as medications (medical therapy) that you may need to drink or even stop for safety reasons. You will most likely be referred to perinatologists.

A team-based approach with you, perinatologists, obstetricians, and cardiologists will help determine how to keep you and your baby healthy during pregnancy, as well as the best method for childbirth, whether naturally or by cesarean section.

Risk of pregnancy in women with congenital heart defects

Although many women with congenital heart defects are able to give birth successfully, a careful risk assessment is very important. Heart disease is the number 1 cause of death in women worldwide, and women with congenital heart disease in some cases will be more unable to tolerate cardiovascular changes that accompany pregnancy and birth.

Currently, below are examples of congenital heart disorders that do not greatly increase the risk to the mother (individual cases vary):

  • Ventricular septal or septal abnormalities (without other abnormalities)
  • Aortic coercion - after treatment
  • Tetralogy Fallot - after surgery

Examples of forms of congenital heart disease at high risk for pregnancy include:

  • Lung hypertension
  • Eisenmenger syndrome
  • Severe aortic stenosis or other valve abnormalities
  • Single ventricular heart disease (where the heart has only one chamber capable of pumping blood out of the heart, rather than two) or other forms of cyanotic heart disease

Cardiologists can advise you on whether your congenital heart disorder carries a high, moderate, or low risk - and the best way to protect your health and your baby's health.

Questions to the doctor about pregnancy and congenital heart disease

The questions below can help you talk to your doctor. Print or record this question and take it for a visit. Taking notes can help you remember the doctor's response when you go home.

  • As a woman with congenital heart disease, is pregnancy safe for me?
  • As a man or woman with congenital heart disease, is my child more likely to have congenital heart disease?
  • If pregnancy is not recommended, what are my contraceptive options?
  • Are some forms of contraception safer than others?

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