Pregnancy of heart disease patients, or cardiovascular diseases caused by pregnancy, is one of the four major causes of maternal death, although it is not so common, accounting for about 1% of all pregnant women.
Because when pregnant, the mother’s body produces a series of changes, at the same time the growth and development of the fetus, all increase the burden of the cardiovascular system, may cause cardiac dysfunction, and heart failure. Therefore, in the pre-pregnancy consultation and different periods of pregnancy, should properly pay attention to pregnant women with heart disease.
We have sorted out some common questions about pregnancy and cardiovascular diseases.
Will pregnancy affect the heart what?
After conception, a series of hormones in the body will increase, causing water and sodium retention, and the blood volume in the pregnant woman’s body will increase with the month of pregnancy. Generally, the blood volume will gradually increase at 6 weeks of pregnancy, reaching a peak at 32-34 weeks, and returning to normal level at 2-6 weeks after delivery.
With the development of the fetus, the uterus increases, the metabolism of the mother increases, and the workload of the heart increases. And the enlarged uterus will push the heart upward and left, Some mothers may have symptoms and signs similar to heart disease, such as palpitation, shortness of breath, chest tightness, accelerated heart rate, arrhythmia, heart murmur, elevated blood pressure, etc. However, most of the conditions are normal and need not be excessively nervous. If you have any discomfort, you can consult your cardiologist and obstetrician and gynecologist in time to decide whether to further examine.
Originally there was a heart disease, can you be pregnant and have children?
Most patients with mild cardiovascular diseases can safely pass through pregnancy and childbirth and give birth to healthy babies. For example, some diseases with normal cardiac function and unchanged cardiac structural changes, such as atrial septal defect, ventricular septal defect, mitral valve prolapse, mitral valve insufficiency, etc. Or some benign arrhythmia, such as sinus tachycardia, supraventricular tachycardia with infrequent attacks, premature heartbeat, etc.
However, it is still necessary to remind young women suffering from certain cardiovascular diseases that they must consult a cardiologist before pregnancy and do some corresponding examinations, such as electrocardiogram and echocardiography. The doctor will suggest whether it is suitable for pregnancy and matters needing attention during pregnancy.
Since heart disease is still the main cause of maternal death, timely joint diagnosis and treatment by cardiologists and obstetricians and gynecologists can often reduce the risk of deterioration of the disease during pregnancy and childbirth, thus ensuring the safety of pregnant women and fetuses.
How to do with high blood pressure during pregnancy?
Hypertension is the most common cardiovascular disease during pregnancy. Hypertension during pregnancy refers to systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg measured at least twice on the same side of the arm. If systolic blood pressure and diastolic blood pressure are increased by ≥ 30 and ≥ 15 mmHg respectively than normal blood pressure, close observation is also required.
Many cases of acute diseases often occur in the late pregnancy or within 10 days after delivery, accompanied by edema, hypertension and proteinuria to varying degrees. In severe cases, heart failure will occur.
If there are the following situations, we must be especially careful to see if there is any increase in blood pressure:
- Excessive mental stress or stimulation, resulting in central nervous system dysfunction; Cold season or temperature changes too much; Young primipara or elderly primipara; Have a history of chronic hypertension, nephritis, diabetes, etc. Malnutrition, such as hypoproteinemia; Body mass index (BMI) > 24; Uterine tension is too high, such as polyhydramnios, twins, diabetic macrosomia and hydatidiform mole, etc. There is a family history of hypertension, especially if the mother of a pregnant woman has the same medical history.
During pregnancy, blood pressure is usually higher than usual. However, if the blood pressure is higher than 150/90 mmHg, you must consult a cardiologist in time.
Will pregnancy also cause other cardiovascular diseases in what?
1. Arrhythmia
No matter whether there is a heart problem or not, the possibility of arrhythmia during pregnancy will increase. Healthy pregnant women also suffer from arrhythmia (frequent atrial and ventricular premature beats), but usually have no effect on the mother or fetus.
Before pregnancy, if there is a history of arrhythmia, such as preexcitation syndrome or other organic heart disease, patients may have new arrhythmia during pregnancy, or aggravate the original arrhythmia. Therefore, be sure to consult a cardiologist regularly before and during pregnancy.
2. Perinatal cardiomyopathy
Patients usually have no history of heart disease and have no abnormal manifestations in the first and second trimester of pregnancy, but they often have dyspnea within 1 month before delivery to 5 months after delivery. About 50% ~ 60% of the patients often have complete or almost complete recovery of clinical status and cardiac function within 6 months after delivery.
Some patients may have worsening clinical symptoms and high mortality rate. Therefore, even mothers with clinical conditions and cardiac function recovery still have the risk of recurrence if they are ready to conceive again.
Because this is an unknown cause of congestive cardiomyopathy, so preventive measures are limited. Generally speaking, pregnant mothers should eat a balanced diet, ensure normal daily life, and prevent respiratory tract and digestive tract infection.
If the above aspects are noticed, even if dyspnea occurs in the last month of pregnancy, it may slow down the severity of the disease. In short, timely examination and treatment are of vital importance.
Suspected of possible heart problems, can what examination be done during pregnancy?
Electrocardiogram, including common electrocardiogram, exercise electrocardiogram, 24-hour dynamic electrocardiogram and echocardiography, is non-invasive and radiation-free, safe for pregnant women and fetuses, and is the preferred screening method for cardiovascular diseases during pregnancy.
Among them, 24-hour dynamic electrocardiogram can record the heartbeat throughout the day, whether there is tachycardia or bradycardia, whether there is conduction block, etc.
In addition, electrocardiogram exercise test can evaluate cardiac functional volume, chronotropy, blood pressure response and exercise-induced arrhythmia or myocardial ischemia. Patients with known heart diseases should undergo this examination before pregnancy.