Cardiovascular disease during pregnancy can pose unique challenges. Increased blood volume and heart rate, along with other changes that occur during pregnancy, can put additional strain on the heart, which can complicate pre-existing conditions and introduce new cardiovascular issues.
At Brigham and Women’s Hospital (BWH), we provide highly specialized care for women with cardiovascular disease before, during, and after pregnancy as part of the Cardiovascular Disease and Pregnancy Program. Our multidisciplinary team of experts, including maternal-fetal medicine (high-risk pregnancy) specialists, cardiologists, interventional cardiologists, cardiac surgeons, and specialized nurses, is dedicated to delivering the highest level of care for both the mother and her baby.
Pre-existing Conditions
Pre-existing cardiovascular conditions may include:
- Congenital heart disease and defects
- Abnormal heart rhythms (arrhythmias)
- High blood pressure (hypertension)
- Structural heart disease
- Coronary artery disease
- Vascular disease
Cardiovascular Conditions Arising During and After Pregnancy
Cardiovascular conditions that arise during pregnancy may include:
- Abnormal heart rhythms
- High blood pressure
- Peripartum cardiomyopathy (heart failure)
- Vascular disease
Optimal Care for Cardiovascular Disease and Pregnancy
Women with pre-existing cardiovascular conditions who are planning a pregnancy and women who develop cardiovascular issues during pregnancy require specialized care. In these cases, it is important that a team of specialists in many disciplines – including maternal-fetal medicine (experts in high-risk pregnancy), cardiology, interventional cardiology, and cardiac surgery – be closely involved in the care of both the mother and the baby.
Preconception Planning
Whenever possible, planning with the medical team should begin before conception for women with pre-existing cardiovascular conditions in order to best understand the risks of pregnancy and how to manage conditions safely during pregnancy. Improvement in fitness level, adjustments in medication, and other recommendations may also be made prior to conception to prepare for the changes that occur during pregnancy.
Prenatal Care
A detailed prenatal care plan is developed to address the mother’s individual health issues. A comprehensive assessment of conditions and symptoms should be performed, including advanced cardiovascular imaging techniques that are safe for use during pregnancy. Ideally, medication adjustments and planning are started before or early in the pregnancy.
