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Women who have a heart valve disease and want to become pregnant have some special
considerations. A valve disease may increase the risk
to the mother and the developing baby (fetus). Treatment of a valve disease might have to change during a pregnancy.
How much a heart valve disease increases risks during pregnancy depends on the type of valve disease and how bad it is.
If you have a heart valve disease and are considering pregnancy, talk with your doctors. You can get more
information about your individual risk factors and treatment needs before and after pregnancy.
Heart valve problems that may increase the risk of problems during pregnancy include:1
If you have a mild or moderate form of valve disease, and if your heart is pumping blood normally, you can likely have a normal pregnancy with careful medical supervision. Simple practices such as getting plenty of bed rest and avoiding
lying on your back can play important roles in successfully managing your
pregnancy. You might also take medicines during pregnancy.
If you have more severe valve disease with symptoms, you have a higher risk of problems during pregnancy. Your doctors may suggest that you consider surgery before you get pregnant. This might include a valve replacement surgery or a balloon valvotomy, depending on what type of valve problem you have.
You already have a replaced valve, and you take warfarin. Talk with your doctor if you plan on getting pregnant. You will not take warfarin if you are pregnant, because it can cause miscarriage or birth defects. You and your doctor will decide what blood thinner you will take while you are trying to get pregnant. You might take heparin during your pregnancy.
You are thinking about having a heart valve replaced before you get pregnant. You will have a choice of the type of heart valve you will get. The heart valve type you choose may depend on whether you plan to get pregnant in the future.
Treatments for a valve problem during pregnancy depend on the type of valve problem and how bad it is.
Medicine choices might include medicines that flush excess fluid out of the body
(diuretics) and medicines to relax and expand the blood vessels.
A procedure that widens a heart valve might be done during pregnancy if the woman develops symptoms. This procedure, called a balloon valvuloplasty or valvotomy, is done for diseases that cause a heart valve to narrow (aortic valve stenosis and mitral valve stenosis). After the woman delivers, she may then have valve replacement surgery.1
Bonow RO, et al. (2008). 2008 Focused update
incorporated into the ACC/AHA 2006 Guidelines for the management of patients
with valvular heart disease: A report of the American College of
Cardiology/American Heart Association Task Force on Practice Guidelines
(Writing committee to revise the 1998 Guidelines for the management of patients
with valvular heart disease). Circulation, 118(15):
November 11, 2013
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & David C. Stuesse, MD - Cardiac and Thoracic Surgery
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