Pregnancy, if Monitored, Deemed Safe for Women with High-Risk Congenital Heart Disease

Women with high-risk congenital heart disease can safely become pregnant and give birth if they are carefully monitored and managed by doctors, according to a new scientific statement by the American Heart Association.

“Management Of Pregnancy In Patients With Complex Congenital Heart Disease: A Scientific Statement For Healthcare Professionals From The American Heart Association” was written by experts from several research and health institutions, and published in the journal Circulation.

Pregnancy can be more risky for patients with complex congenital heart disease — including pulmonary hypertension, single ventricle, transposition of the great arteries, Eisenmenger syndrome, and severe aortic stenosis — than for women with milder forms of the disease, regardless of whether they are clinically stable at the time of conception.

“Women with complex congenital heart disease were previously advised not to get pregnant because of the risk to their life,” Mary Canobbio, RN, MN, chairwoman of the committee responsible for the scientific statement, said in a news release. “Now scientific research demonstrates that with proper management in the hands of experienced cardiologists and obstetricians, these women can have successful pregnancies.”

The statement provides an overview of what doctors should do to manage pregnant patients with complex congenital heart disease. It recommends, for example, that patients receive counseling before becoming pregnant so they understand how their health and that of their child might be affected. Follow-up should continue during pregnancy and after delivery, the statement said.

Patients should deliver in a medical center with a team of specialists trained to manage complex congenital heart disease, including a cardiologist, obstetricians, cardiac anesthetists, and surgeons, the statement said. Once the baby is born, doctors should follow the heart patient and her child for six weeks to six months.

The statement focuses on “what we know about the risks for these patients, what the potential complications are, what cardiologists, advanced practice nurses and other cardiac health providers should discuss in counseling these women, and once pregnant, recommendations in terms of things we should be looking out for when caring for these women,” Canobbio said.