Contributor: Louise Wilkins-Haug, MD, PhD
Louise Wilkins-Haug, MD, PhD, is Division Director of Maternal-Fetal Medicine at BWH and a Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School.
When 29-year-old Chelsea was in the second trimester of her pregnancy with her daughter Aria, she began experiencing dizziness and shortness-of-breath. An echocardiogram revealed that one of her heart valves had deteriorated.
Chelsea was referred to the Cardiovascular Disease and Pregnancy Program at Brigham and Women’s Hospital, where a team including high-risk pregnancy (maternal-fetal medicine) specialists, cardiologists, and cardiac surgeons worked together to develop a specialized plan for her care. This included delivering her baby in a hybrid operating suite at Brigham and Women's Hospital to enable the team to quickly respond with a range of treatments for Chelsea’s heart condition if needed during the delivery. Chelsea delivered a healthy baby girl and had successful valve replacement surgery at BWH the following week.
Women with heart disease like Chelsea, are one of several groups that may benefit from high-risk pregnancy care. These groups include women with other preexisting medical conditions, women who develop complications during pregnancy, women at risk for premature birth, and women of advanced maternal age (35 years of age or older). Maternal-fetal medicine specialists provide individualized care before, during, and after pregnancy for women who are considered high-risk.
High-risk pregnancy specialists often work closely with other specialists (such as cardiologists, rheumatologists, gastroenterologists, and psychiatrists) to make adjustments to a woman’s medications prior to and during pregnancy. They also recommend key nutritional supplementation and lifestyle changes to help reduce risks during pregnancy.
During high-risk pregnancy, there may be concerns about how the baby is developing. In addition to closely monitoring the mother’s condition, high-risk pregnancy specialists track the baby’s development and may provide treatment to support the baby’s developing systems. In some cases, they may be able to correct certain conditions before the baby is born.
Conditions that develop during pregnancy also can place the mother at long-term risk for health complications. Up to 60 percent of women who have gestational diabetes end up with Type 2 diabetes, and women who experience preeclampsia (a condition characterized by high blood pressure) have a higher risk of developing cardiovascular disease throughout their lifetime. High-risk pregnancy specialists help women after delivery and work with their primary care physicians with the goal of improving their health for many years after pregnancy.
Chelsea received specialized high-risk pregnancy care at BWH when she was diagnosed with a failing heart valve during her pregnancy with her daughter Aria.
We understand that you may have concerns and want to assure you that we are steadfast in our commitment to safely providing the care you need. Our maternal-fetal medicine specialists are available to connect with you in person and with Virtual Visits. To request an appointment, call 617-732-5130 or submit the form below.
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