Managing pregnancy with a health condition can be tricky, but knowing the facts can help women make the best decisions. According to recent recommendations from the European Society of Cardiology, pregnant women with heart disease should not go past 40 weeks gestation. Here's what else they need to know about being pregnant with a heart condition.
The 2018 European Society of Cardiology's guidelines for the management of cardiovascular diseases while pregnant was recently published online in the European Heart Journal, as well as the ESC website. The guidelines included a recommendation that women with heart disease give birth at no later than 40 weeks gestation, according to Science Daily.
Professor Jolien Roos-Hesselink, Co-Chairperson of the Guidelines Task Force and Cardiologist, Erasmus Medical Centre Rotterdam, the Netherlands told the outlet that pregnancy beyond 40 weeks has "no added benefit for the baby and may even have negative effects." For this reason, labor should be induced or a Caesarean Section should be induced at 40 weeks, according to Science Daily. While many pregnancy risks are increased when women have a heart disease, it is possible to safely manage cardiovascular conditions and have a successful pregnancy. In such cases, knowledge and preparation are key. The added recommendation concerning gestational time adds to the existing advice for pregnant women with heart disease and other cardiovascular conditions.
Heart disease poses a big risk to pregnant women. Your heart is working overtime throughout pregnancy, pumping 40 percent more blood to your organs, according to Parents. For that reason, those with heart disease have a much greater risk of death or heart failure during pregnancy, Science Daily reported. And while most women with heart disease go on to have a perfectly healthy pregnancy, they are at a higher risk of premature labor, preeclampsia, and postpartum hemorrhage.
An important part of having a healthy pregnancy with a heart condition is preparation. “It’s important not to fall pregnant accidentally,” Stephanie Martin, D.O., medical director for labor and delivery and the obstetric intensive care unit at the Texas Children's Pavilion for Women in Houston told Parents. Birth control and family planning are especially important for women with heart issues, she said:
Think about contraception. There are several heart conditions where you will not be able to take the combined pill. If you are taking a progestogen-only pill, get advice to ensure you choose the most effective one.
Additionally, it may be wise to have children at a younger age if you have a bad heart. Dr. Sara Thorne, a Consultant Cardiologist at Queen Elizabeth Hospital Birmingham, who specializes in adult congenital heart disease and heart disease in pregnancy, told the British Heart Association as much:
Pregnancy may make your condition worse, so consider how you would cope with a baby. And if you have a heart condition, it may be better to have your family in your 20s — don’t put it off.
Thorne went on to explain that seeing a specialist is a part of proper planning before trying to conceive, according to the BHA:
It’s important to see the right cardiologist, preferably alongside an obstetrician. If you’re being seen by a congenital heart disease service, they should have the right degree of knowledge, but if you’re seeing a general cardiologist, you may need to ask to be referred to a specialist.
Managing blood pressure during pregnancy is another important step, according to the America Heart Association. If you have high blood pressure, seek assistance in lowering it before conceiving. To this end, the AHA recommends that prior to getting pregnant, women eat well, limit sodium intake, begin and maintain 150 minutes of physical activity each week, be at a healthy weight, and refrain from using alcohol and tobacco. All of these recommendations, including the new 40 week limit, combine to empower women to make the best decision for themselves and their families.