Congenital Heart Disease and Pregnancy
There are increasing numbers of women with congenital (from birth) heart disease that are now reaching childbearing age and proceeding to have pregnancies. These women may have been born with an atrial septal defect or ventricular septal defect, bicuspid aortic valve, coarctation of the aorta, or tetralogy of fallot.
Women from the Northwestern Adult Congenital Heart Program are referred to the Heart Disease and Pregnancy Program for management of pregnancy. Women with a congenital defect in their heart may have required surgery as a child. The surgery enables them to develop normally and consider planning a family. As they grow into adulthood, additional cardiac problems may arise which could mean an increased risk of complications during pregnancy. The risk of congenital heart disease in their offspring is increased compared to the general population. In these cases, the heart of the fetus is examined with ultrasound by a pediatric cardiologist during pregnancy.
In the Heart Disease and Pregnancy Program there have been multiple successful pregnancies in women with unrepaired atrial septal and ventricular septal defects, bicuspid aortic valves, or coarctation of the aorta, but most have been corrected prior to pregnancy. Intervention before a pregnancy may help prevent problems during future pregnancies.
Women with Marfan syndrome also have an increased risk of complications during pregnancy. Marfan syndrome is a congenital disease that affects the connective tissue of the body. The primary purpose of connective tissue is to hold the body together and provide a framework for growth and development. Women with Marfan syndrome may be at risk for further enlargement of the aorta as pregnancy progresses requiring frequent monitoring of the cardiac status throughout the pregnancy.
Whether the congenital heart defect was discovered in childhood or in adulthood, this group of patients should have a preconception evaluation, as they may require an intervention that could improve their chances of having an uncomplicated pregnancy.
Heart Disease and Pregnancy Program