Pregnant women with heart disease are recommended to give birth no later than 40 weeks of gestation. “Beyond 40 weeks, pregnancy has no added benefit for the baby and may even have negative effects,” said lead researcher, Jolien Roos-Hesselink.
“Pregnancy is a risky period for women with heart disease because it puts additional stress on the heart, so the guidelines advise inducing labour or a cesarean section at 40 weeks,” Hesselink added.
Heart disease is the main reason why women die during pregnancy in many western countries. In comparison to healthy pregnant women, those with heart disease have a 100 times greater risk of death or heart failure.
Most women with heart disease have a healthy pregnancy, but researchers recommend that they should be aware that they have a higher risk of obstetric complications, including premature labour, pre-eclampsia, and post-partum bleeding.
An estimated 18-30% of offsprings have complications and up to 4% of neonates die because of such complications.
Researchers time and again have recommended that In-Vitro fertilisation (IVF) is not for a pregnant woman with a heart disease since the said process often uses high doses of hormones, which increase the risk of thrombosis and heart failure.
Also carrying more than one baby puts more stress on the heart; therefore the women with heart disease undergoing IVF are strongly advised to transfer a single embryo. Furthermore, women with congenital heart diseases, for example, pulmonary arterial hypertension, severely dilated aorta, or severely reduced ability of the heart to pump blood, need contraception advice to avoid unplanned pregnancy.
“When drug companies have no data on whether a drug is safe during pregnancy and breastfeeding they tend to say it is not recommended. It may be appropriate to give a drug to a severely ill woman if there are no harmful side effects noted in the databases listed in the guidelines,” said another researcher Vera Regitz-Zagrosek.
Therefore a delivery plan should be devised at 20-30 weeks, specifying vaginal or cesarean delivery for pregnant women suffering from such diseases.
“The delivery plan should be available 24 hours a day so that when a pregnant woman with heart disease arrives at the hospital in labour hospital staff knows exactly what to do,” Hesselink further added.