COMMON CARDIOVASCULAR DISEASES OF PREGNANCY
During pregnancy, the female body changes a lot in term of psychology, anatomy, physiology, hematology, circulation, etc. A healthy cardiovascular system is essential to adapt to those changes. However, for women with cardiovascular disease, pregnancy becomes a burden and makes cardiovascular disease worse and complications for the mother and fetus. Therefore, it is important to monitor cardiovascular disease during pregnancy.
Some common cardiovascular diseases in pregnancy
Ischemic heart disease
Pregnant women or non-pregnant women all have the same risk factors for heart attack. The risk of infarction is increased in cases of multiple pregnancies, smokers, patients with diabetes, obesity, hypertension and high blood fat .
Heart attack is most common in the last 3 months of pregnancy and maternal mortality of about 20%. Treatment is similar for a non-pregnant person.
Arrhythmia and pregnancy
Atrial and ventricular ectopic pattern is a common condition during pregnancy. She felt a strong heartbeat in her chest and found a rhythm after the systolic rhythm. Tachycardia is also common during pregnancy.
About 20% of women who have a supraventricular tachycardia before pregnancy will relapse during pregnancy. Therefore, pregnant women need to be monitored cardiovascular during pregnancy.
Mitral valve stenosis
Mitral valve disease onset is usually asymptomatic, but during pregnancy can worsen due to tachycardia, arrhythmia, or increased blood supply, leading to serious complications such as acute pulmonary edema, and, if untreated, will quickly lead to death.
Therefore, women with severe mitral stenosis need to be consulted by a cardiologist and usually treat valve dilatation or mitral valve repair/replacement before pregnancy.
Open mitral valve
Pregnant women, if well tolerated, sometimes the pregnancy process is still normal (common in women with good compensatory cardiac function).
However, in women with severe mitral regurgitation and impaired cardiac function, pregnancy is more likely to have complications during childbirth.
Aortic valve stenosis
Aortic valve stenosis is usually congenital or a consequence of rheumatic heart disease. If the aortic stenosis is severe or has symptoms such as difficulty breathing, chest pain, then the patient should not be advised to become pregnant until having surgery.
Open aortic valve
Women are usually well tolerated when cardiac function is within normal limits. It should be noted that some drugs during pregnancy such as “ACE inhibitors” (drugs often used for treatment in aortic valve regurgitation) are at risk of birth defects in the fetus, so they need to be replaced with another group.
Mechanical valve and pregnancy
Women with an artificial heart valve (who had a mechanical artificial valve replaced before pregnancy) need to take lifelong anticoagulants and must continue throughout pregnancy. However, anticoagulants such as wafarin (Sintrom) and other derivatives can lead to fetal pathology between 6 and 12 weeks, while increasing the risk of miscarriage, stillbirth and intracranial hemorrhage. Therefore, for patients with mechanical heart valves, pregnancy will lead to a great risk for both mother and fetus. If the pregnancy continues, prenatal wafarin should be stopped and replaced with another anticoagulant heparin for 10 days before delivery. During childbirth, heparin should be discontinued and wafarin given again on day 2 or 3 after birth.
Other uncommon heart conditions during pregnancy such as: Increased pulmonary arterial pressure, obstructive hypertrophic cardiomyopathy, obstetrical cardiomyopathy (a special pathology associated with the pregnancy process), etc. For pregnant women in general, especially, women with heart disease, should be monitored and managed pregnancy periodically according to the instructions of medical staff. Women with associated cardiovascular disease should be examined and combined with a cardiologist to reduce the risk of complications and complications during pregnancy, and ensure health for both mother and baby.