Pregnancy and Adult Congenital Heart Defects

More females with congenital heart defects (CHD) are surviving — and thriving — into adolescence and adulthood. All females with CHD should receive counseling when they are sexually active and especially when they plan to or become pregnant. A thorough assessment of their current cardiac status will help provide appropriate advice on how their cardiovascular system is likely to cope with the physical changes that occur during pregnancy and after delivery.

Patients (both males and females) will need to consider the following:

• Genetic aspects of their heart defect
• Risk of recurrence of their heart defect
• Health and life expectations related to their heart defect
• Risk of future complications of their heart defect.

A mother's safety during pregnancy can, in part, be determined by certain risk factors including:

• Her physical abilities when not pregnant (poor abilities tend to predict poor tolerance of pregnancy)
• The strength of her main pumping chamber when not pregnant (very weak ventricles may well have difficulties tolerating a pregnancy)
• The presence of cyanosis (bluish tinge to tissues from shortage of oxygen)
• Prior cardiac events such as heart failure, important heart rhythm problems, stroke, or transient ischemic attack
• Obstruction of the left heart resulting from mitral or aortic valve disease
• Enlarged aortas, especially in Marfan patients
• The need to take coumadin (a blood thinner)

Each woman with CHD is an individual, and will need to be evaluated by an experienced cardiologist. Some defects, however, are more likely to lead to moderate or high risk of complications during pregnancy. They include:

• Eisenmenger’s syndrome and other causes of very high pressures in the pulmonary arteries
• Cyanotic conditions
• Fontan procedure
• Uncorrected coarctation of the aorta

Need an appointment? Request one online 24 hours a day, 7 days a week; or call 800-789-PENN (7366) to speak to a referral counselor.