Pregnancy and Heart Disease

Pregnancy increases stress on a woman’s heart and circulatory system, posing significant, sometimes life-threatening, risks for mothers and their babies. This includes women who have pre-existing heart conditions and those who develop conditions during pregnancy.

Changes to the heart and circulatory system during pregnancy include:

  • Increased blood volume
  • Increased amount of blood pumped by the heart
  • Increased heart rate
  • Lowered blood pressure

These factors lead to increased risks for heart rhythm abnormalities, heart valve (artificial or natural) issues and congestive heart failure in pregnant mothers. Also, if a mother was born with a heart defect, her baby has an increased risk of developing a congenital heart defect.

Combining clinical and research expertise in cardiovascular disease and high-risk obstetrics, the Brigham and Women’s Hospital (BWH) Heart & Vascular Center cares for women with significant medical conditions who either are pregnant or would like to become pregnant.

Our specialists use a multidisciplinary approach to diagnose and treat women with arrhythmia, cardiomyopathy, coronary artery disease, structural heart disease, vascular disease and other serious cardiovascular conditions. This includes care for women with pre-existing heart and vascular disease or for women who develop cardiovascular conditions during pregnancy. Experts from interventional cardiology, cardiac surgery, adult congenital heart disease, vascular medicine, electrophysiology, high-risk obstetrics, prenatal genetics, infertility, reproductive surgery and other specialties collaborate to ensure that women are carefully evaluated and treated to address both their health and their child’s health.

Pregnancy and Heart Disease Topics

Risk Factors for Heart Disease in Pregnancy

A number of factors may contribute to the development of heart disease, including:

Diagnosis of Heart Disease in Pregnancy

Cardiovascular specialists in the Complex Consultative Cardiology Program provide expert evaluation and diagnosis with the aid of the latest in advanced imaging technologies, including techniques that are safe for use during pregnancy. Along with a careful physical examination, the cardiologist may order one or more of the following tests or procedures, with some only used before a woman becomes pregnant:

Treatment for Heart Disease in Pregnancy

Whenever possible, cardiovascular issues are addressed prior to conception to manage existing conditions safely during pregnancy, including coordinating care with cardiac surgeons, interventional cardiologists and electrophysiologists. For women with congenital heart disease or other pre-existing cardiovascular conditions who are considering pregnancy, specialists may adjust medications and will communicate risks of pregnancy and the steps that you should take prior to conception.

Our specialists develop individualized treatment plans for patients based on:

  • Age
  • Expectations for course of the disease
  • Overall health
  • Medical history
  • Presence of other conditions
  • Severity and form of the disease
  • Tolerance for specific medications or procedures
  • Whether the patient is pregnant

Treatment, ranging from lifestyle changes to surgery, may include:

Medicine

Interventional and surgical procedures performed prior to pregnancy include:

What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic for pre-operative information and tests.

The day of surgery, you care will be provided by surgeons, anesthesiologists and nurses who specialize in surgery for women with heart conditions. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center Staff members will provide surgery updates and caregivers who leave the hospital will be contacted by cell phone.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

Patients benefit from the teamwork of obstetricians, medical cardiologists, interventional cardiologists, cardiac surgeons, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in heart conditions. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

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