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Pregnant Women Need Specialised Care If They Have Heart Disease

Pregnant Women Need Specialised Care If They Have Heart Disease

Diabetes, high blood pressure, high cholesterol, and related cardiovascular conditions are becoming increasingly common with a combination of bad lifestyle choices and sedentary jobs, which are becoming even more sedentary as technology advances. Pregnancy enhances the load on the cardiovascular system by 30% to 50% and previously unknown conditions can start having effects. Cardiovascular diseases are the leading cause of complications and death resulting from pregnancy.


Pregnancy also affects the medications and treatments that can be safely taken and this further enhances the risk. It is important to monitor your cardiovascular health and get counseling throughout the period from before conception to after the birth of the child. Some complications of pregnancy can also affect the long-term health of the mother. A complication known as pre-eclampsia which leads to dangerously high blood pressure levels can lead to a lifelong increase in the risk of developing a stroke. Women with preexisting disease of the heart valves should take extra precautions. Treatment with medications that reduce the clotting of blood can reduce the chances of developing ischemic stroke.


As the average age of motherhood increases, the risk of cardiovascular complications also increases. The number of heart rhythm disorders occurring during pregnancy has been rising. Age above 35 years is also associated with a higher risk of premature birth, pre-eclampsia, gestational diabetes, and chronic hypertension. You can read more in detail about the heart conditions that can affect pregnancy in our article here.


Care for a pregnant woman with heart conditions should be done by a team that includes an obstetrician, a cardiologist, a fetal medicine specialist, and an anesthesiologist.


How does the functioning of your cardiovascular system change during pregnancy?


The cardiovascular system changes and evolves as the pregnancy advances. Here are some of the changes:

  • Increase in the mass of the Left Ventricle. This effect is higher in multiple gestations and in pre-eclampsia patients
  • The dilation of the ventricle increases during the first 2/3rds of the pregnancy and decreases during the last 1/3rd.
  • Decrease in resistance from small blood vessels in your body due to their dilatation under the effect of the hormone progesterone
  • Increase in cardiac output as the pregnancy progresses to about 50% more by the 20th week and a sudden increase by up to 15% in the first stage of labour and a 60-80% increase in the second stage of labour as about 300-500ml of blood starts recirculating in the mother’s system. In twins, the cardiac output is further enhanced by another 10-20%.
  • Blood pressure starts falling during mid-pregnancy and returns to normal as the pregnancy nears term
  • The overall blood volume increases
  • Changes in ECG patterns can be observed in pregnant patients


How should you prepare for pregnancy?


It is advisable to schedule an appointment with a cardiologist and an obstetrician who specializes in high-risk pregnancies. Your medical team can evaluate and monitor key parameters of your health. You may be advised of treatment and lifestyle changes. It is important to tell your team about all medications you take as not all medications are safe during pregnancy.


Can a healthier lifestyle help?


A healthier lifestyle before, during, and after pregnancy can go a long way in protecting you from cardiovascular complications. These steps are important not just when a woman has cardiovascular conditions, but even otherwise for better health and prospects of the baby and the mother. A healthy lifestyle in combination with expert care and monitoring can keep the risk of complications to a minimum. 


Here are a few steps that can help:

  • Healthy diet
  • Moderate exercise and physical activity
  • Smoking cessation
  • Staying away from alcohol and caffeine
Dr. Pooja Mittal
Obstetrics & Gynaecology
Meet The Doctor
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