Women with high-risk congenital heart disease have traditionally been advised to avoid pregnancy, but that is no longer the case if the pregnancy is managed properly, according to a new American Heart Association scientific statement.
“Women with complex congenital heart disease were previously advised not to get pregnant because of the risk to their life,” Mary M. Canobbio, RN, MN, FAHA, lecturer at the UCLA School of Nursing and chair of the writing committee for the scientific statement, said in a press release. “Now scientific research demonstrates that with proper management in the hands of experienced cardiologists and obstetricians, these women can have successful pregnancies.”
Canobbio and colleagues recommended that women with complex congenital heart disease — including single ventricle, transposition of the great arteries, pulmonary hypertension, Eisenmenger’s syndrome and severe aortic stenosis — undergo prepregnancy counseling to better understand how pregnancy can affect their health and that of their child.
Once pregnancy occurs, a delivery plan should be devised to anticipate any problems that could happen during and after delivery, according to the authors.
Delivery should occur at a traditional medical center with a cardiologist trained in managing complex congenital heart disease, obstetricians trained in high-risk maternal–fetal medicine, cardiac anesthesia and a cardiac surgical team, Canobbio and colleagues wrote.
Monitoring should continue for 6 weeks to 6 months after delivery, they wrote.
Canobbio said in the release that the statement covers “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.” – by Erik Swain
The authors report no relevant financial disclosures. One reviewer reports serving as an expert witness in two maternal mortality cases.