Understanding pregnancy and heart disease

Pregnancy is a beautiful journey, but for women with heart disease, it can also be a challenging one. Let's explore how pregnancy affects the heart, what risks it brings for those with heart conditions, and how these can be managed to ensure both mother and baby stay healthy.

Changes in the body during pregnancy

When a woman becomes pregnant, her body undergoes many changes to support the growing baby. These changes can significantly impact the heart. Here are some key points:

Increased blood volume: During pregnancy, the amount of blood in a woman's body increases by about 50%. This extra blood is necessary to supply the baby with oxygen and nutrients.

Heart's Workload: The heart has to pump more blood with each beat, increasing its workload by 30-50%.

Faster heart rate: A pregnant woman's heart beats faster, with an increase of about 10-20 beats per minute.

Blood pressure changes: Blood pressure might decrease initially but can rise later in pregnancy, especially if there are complications.

These changes can be hard for women with existing heart problems, making careful monitoring essential.

Identifying high-risk women

Not all women with heart disease face the same risks during pregnancy. Some conditions pose higher risks than others. Here are factors that increase risk:

Severe heart conditions: Women with serious heart issues like pulmonary hypertension or severe valve problems are at high risk.

Previous heart problems: Women who have had heart failure or heart attacks before are also at greater risk.

Symptoms and history: Women with symptoms like severe shortness of breath or chest pain before pregnancy need special attention.

Women with these high-risk factors should receive counseling and careful monitoring throughout their pregnancy.

Managing heart problems during pregnancy

For women with heart disease, managing their condition during pregnancy involves regular check-ups and sometimes medications. Here are some common heart-related issues and how they are managed:

Hypertension: This is common during pregnancy and can lead to serious problems like pre-eclampsia, a condition causing high blood pressure and organ damage. Women with chronic hypertension need regular monitoring and may need medication to keep their blood pressure under control.

Heart failure: This can be managed with medications that are safe for both mother and baby. Women with heart failure need close monitoring to adjust their treatment as needed.

Heart attacks: Though rare, heart attacks can occur during pregnancy. Women at risk need to avoid smoking, manage diabetes, and keep their blood pressure in check.

Monitoring during and after pregnancy

Women with heart disease should be closely monitored during pregnancy and after giving birth. Here's why:

Labor and Delivery: During labor, the heart's workload increases even more. It's essential to manage pain and stress to avoid complications.

Postpartum Period: After delivery, the body undergoes rapid changes, including a sudden shift in blood volume. This can be risky for women with heart disease. Monitoring continues to ensure the heart is coping well.

Preventing complications

Several strategies can help prevent complications for pregnant women with heart disease:

Low-dose aspirin: Starting low-dose aspirin between 12 and 16 weeks of pregnancy can reduce the risk of pre-eclampsia.

Healthy lifestyle: Eating a balanced diet, avoiding smoking and alcohol, and staying active can help manage heart disease during pregnancy.

Regular check-ups: Frequent visits to the doctor help catch and manage any issues early.

Long-term health

Pregnancy complications can sometimes signal future heart problems. Women who experience high blood pressure or pre-eclampsia during pregnancy have a higher risk of heart disease later in life. Regular check-ups with a healthcare provider and maintaining a healthy lifestyle can help manage these risks.

Notable take away points about heart disease and pregnancy

Pregnancy and heart disease: Pregnancy puts extra strain on the heart, which can be challenging for women with heart conditions.

High-risk factors: Some heart conditions and symptoms make pregnancy riskier and require special care.

Managing heart health: Regular monitoring, appropriate medications, and a healthy lifestyle are crucial for managing heart disease during pregnancy.

Monitoring and prevention: Close monitoring during and after pregnancy helps prevent complications and manage any arising issues.

Long-term health: Pregnancy complications can indicate future heart health risks, so ongoing care is important.

By understanding these aspects, women with heart disease can better prepare for a healthy pregnancy and delivery, ensuring the best outcomes for themselves and their babies.

By Dr Barbara Karau, Consultant Cardiologist and Dr Hazel Kariuki, Cardiology Fellow, Aga Khan University Hospital, Nairobi

This article was first published in Business Daily on June 15, 2024