<p><span style="font-family: helvetica;"><img src="/nairobi/PublishingImages/pregnancy%20and%20heart%20disease%20body%20image.jpg" alt="" style="margin: 5px;"/>
</span></p><p><span style="font-family: helvetica;">Pregnancy is a beautiful journey, but for women with heart disease, it can also be a challenging one. Let&#39;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.
</span></p><p><strong style="font-family: helvetica;">Changes in the body during pregnancy</strong></p><p><span style="font-family: helvetica;">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:</span></p><p><span style="font-family: helvetica;">Increased blood volume: During pregnancy, the amount of blood in a woman&#39;s body increases by about 50%. This extra blood is necessary to supply the baby with oxygen and nutrients.</span></p><p><span style="font-family: helvetica;">Heart&#39;s Workload: The heart has to pump more blood with each beat, increasing its workload by 30-50%.</span></p><p><span style="font-family: helvetica;">Faster heart rate: A pregnant woman&#39;s heart beats faster, with an increase of about 10-20 beats per minute.</span></p><p><span style="font-family: helvetica;">Blood pressure changes: Blood pressure might decrease initially but can rise later in pregnancy, especially if there are complications.</span></p><p><span style="font-family: helvetica;">These changes can be hard for women with existing heart problems, making careful monitoring essential.</span></p><p><span style="font-family: helvetica;"><strong>Identifying high-risk women</strong>
</span></p><p><span style="font-family: helvetica;">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:</span></p><p><span style="font-family: helvetica;">Severe heart conditions: Women with serious heart issues like pulmonary hypertension or severe valve problems are at high risk.</span></p><p><span style="font-family: helvetica;">Previous heart problems: Women who have had heart failure or heart attacks before are also at greater risk.</span></p><p><span style="font-family: helvetica;">Symptoms and history: Women with symptoms like severe shortness of breath or chest pain before pregnancy need special attention.</span></p><p><span style="font-family: helvetica;">Women with these high-risk factors should receive counseling and careful monitoring throughout their pregnancy.</span></p><p><span style="font-family: helvetica;"><strong>Managing heart problems during pregnancy</strong>
</span></p><p><span style="font-family: helvetica;">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:</span></p><p><span style="font-family: helvetica;">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.</span></p><p><span style="font-family: helvetica;">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.</span></p><p><span style="font-family: helvetica;">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.</span></p><p><strong style="font-family: helvetica;">Monitoring during and after pregnancy</strong></p><p><span style="font-family: helvetica;">Women with heart disease should be closely monitored during pregnancy and after giving birth. Here&#39;s why:</span></p><p><span style="font-family: helvetica;">Labor and Delivery: During labor, the heart&#39;s workload increases even more. It&#39;s essential to manage pain and stress to avoid complications.</span></p><p><span style="font-family: helvetica;">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.</span></p><p><strong style="font-family: helvetica;">Preventing complications</strong></p><p><span style="font-family: helvetica;">Several strategies can help prevent complications for pregnant women with heart disease:</span></p><p><span style="font-family: helvetica;">Low-dose aspirin: Starting low-dose aspirin between 12 and 16 weeks of pregnancy can reduce the risk of pre-eclampsia.</span></p><p><span style="font-family: helvetica;">Healthy lifestyle: Eating a balanced diet, avoiding smoking and alcohol, and staying active can help manage heart disease during pregnancy.</span></p><p><span style="font-family: helvetica;">Regular check-ups: Frequent visits to the doctor help catch and manage any issues early.</span></p><p><strong style="font-family: helvetica;">Long-term health</strong></p><p><span style="font-family: helvetica;">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.</span></p><p><strong style="font-family: helvetica;">Notable take away points about heart disease and pregnancy</strong></p><p><span style="font-family: helvetica;">Pregnancy and heart disease: Pregnancy puts extra strain on the heart, which can be challenging for women with heart conditions.
</span></p><p><span style="font-family: helvetica;">High-risk factors: Some heart conditions and symptoms make pregnancy riskier and require special care.
</span></p><p><span style="font-family: helvetica;">Managing heart health: Regular monitoring, appropriate medications, and a healthy lifestyle are crucial for managing heart disease during pregnancy.
</span></p><p><span style="font-family: helvetica;">Monitoring and prevention: Close monitoring during and after pregnancy helps prevent complications and manage any arising issues.
</span></p><p><span style="font-family: helvetica;">Long-term health: Pregnancy complications can indicate future heart health risks, so ongoing care is important.
</span></p><p><span style="font-family: helvetica;">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.</span></p><p><em style="font-family: helvetica;"><strong>By Dr Barbara Karau, Consultant Cardiologist and Dr Hazel Kariuki, Cardiology Fellow, Aga Khan University Hospital, Nairobi</strong></em></p><p><span style="font-family: helvetica;"><em>This article was first published in Business Daily on June 15, 2024</em>
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