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.
When a woman becomes pregnant, her body undergoes many changes to support the growing baby. These 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 percent. This extra blood is necessary to supply the baby with oxygen and nutrients.
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. 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.
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.
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.
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.
Dr Barbara Karau, Consultant Cardiologist and Dr Hazel Kariuki, Cardiology Fellow, Aga Khan University Hospital, Nairobi
