Not only is it generally safe for women with heart disease to carry a child, according to recent data, today, more women with heart disease are becoming pregnant than ever before.
These revelations and more were announced in a late-breaking science session at ESC Congress, one of the largest cardiovascular conferences in the world this past Tuesday. According to new data from The Registry of Pregnancy and Cardiac Disease (ROPAC), a worldwide registry that gathers reliable information on outcomes in women with heart disease and their babies, pregnancy is indeed safe for most women with heart disease.
But Professor Jolien Roos-Hesselink, one of the principal investigators, warned that for some women with heart disease, pregnancy still remains too risky.
“Our study shows that fewer women with heart disease die or have heart failure during pregnancy than ten years ago,” she said. “However, nearly one in ten women with pulmonary arterial hypertension (abnormally high blood pressure in the lungs) died during pregnancy or early post-partum.”
Roos-Hesselink believes that one of the main reasons more women with heart disease are becoming pregnant than in the past is because corrective surgery has vastly improved survival rates, ensuring more women reach reproductive age. In fact, the number of women with conditions considered very high risk by the World Health Organization (WHO) increased from around 1% in 2007 to 10% in 2018.
During pregnancy, a woman’s heart has to pump up to as much as 50 per cent more blood volume, putting even the most healthy heart under considerable stress. Heart rates in pregnant women generally also rise by 10 to 20 per cent, which can be potentially unsafe for those who suffer from heart disease.
Sadly, the leading cause of death for pregnant women in the western world is heart disease. Those who suffer from heart disease have a “100-fold greater risk of death or heart failure” compared to healthy pregnant women. Although most women with heart disease go on to have healthy, uncomplicated pregnancies, it’s important they are made aware of their elevated risks. These risks include premature labour, pre-eclampsia an post-partum bleeding.
New guidelines released this month from the European Society of Cardiology and published in the European Heart Journal recommends that pregnant women with heart disease should not go beyond 40 weeks gestation. Roos-Hesselink, who is also co-chair of the Guidelines Task Force, says that for women with heart disease, it is advised to induce or perform a c-section at 40 weeks as pregnancy puts additional stress on the heart – putting both mom and baby at risk.
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