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Publications

Managing motherhood for heart patients

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Just a few years ago, Megan’s heart condition would have prevented her from having the baby she so desperately wanted. Her condition, aortic stenosis, causes a narrowing of the aortic valve. Left unmanaged, even normal bleeding during labor could have caused the heart to fail, resulting in her death and presenting a grave risk to the baby.

“Until recently, women like Megan were advised to avoid becoming pregnant,” explains maternalfetal medicine specialist Shailen Shah, MD.

While her pregnancy was high-risk, today’s advances in maternal-fetal medicine make it manageable. “Our diagnostic tools, medication management and delivery strategies allow us to control Megan’s progress through pregnancy and minimize the stress on her heart and on the baby,” explains Dr. Shah.

Teamed with cardiology
Dr. Shah collaborates with Virtua cardiologist Robert Singer, MD, to develop an intensive plan of care for each patient and, together, they see a wide range of cardiac abnormalities. Dr. Singer cautions: “There are many cardiac conditions which affect pregnancy, some of which may seem minor. But in fact, any heart condition can be intensified during pregnancy.”

The heart during pregnancy and labor
Pregnancy puts extraordinary stress on a woman’s heart, increasing the heart rate to pump 30 to 50 percent more blood. These changes are essential to supporting the baby with adequate blood flow, but they are particularly hard on a heart that is compromised by disease. Labor and delivery add an even greater burden, with sudden increases in blood flow and pressure. The best approach for women with prior cardiac issues is to be evaluated before becoming pregnant, or immediately upon the identification of a condition which develops during pregnancy.

Are you at risk?
Schedule testing before conception if you’ve had:

  • Congenital heart condition
  • Aortic or mitral stenosis – narrowing of the valves
  • Heart attack
  • Cardiomyopathy – heart failure
  • Arrhythmia, heart murmur, Marfan Syndrome or rheumatic fever