Preconception Counseling for Women with Congenital Heart Disease

Chun-Wei Lu, Mei-Hwan Wu, Jou-Kou Wang, Min-Tai Lin, Chun-An Chen, Shenn-Nan Chiu, Hsin-Hui Chiu

Adult Congenital Heart Center, Department of Pediatric Cardiology, National Taiwan University Children Hospital, Taipei, Taiwan
Address for correspondence and reprint requests:
Chun-Wei Lu, Department of Pediatric Cardiology, National Taiwan University Children Hospital, No. 8, Chung-Shan South Road, 100 Taipei, Taiwan.
Fax: +886-2-2314-7450        Tel: +886-2-2312-3456 Ext. 70356
E-mail: joey4147@ms7.hinet.net

Running Title: Pregnancy in women with congenital heart disease
 
Abstract
With advances that have been made over the recent decades in transcatheter and surgical interventions, most patients with congenital heart disease (CHD) can survive into adulthood.

Overall, probably half of these surviving patients are female. When these female CHD patients reach childbearing age, however, pregnancy management will be a major issue.

In order to meet the demands of fetal growth, the maternal cardiovascular system starts a series of adaptations beginning in early pregnancy.

These adaptations include: decreased systemic and pulmonary vascular resistances, decreased blood pressure, expansion of the blood volume, increased heart rate and increased cardiac output.

For women with CHD, this hemodynamic alteration may increase the risks of adverse cardiovascular events as well as the fetal and neonatal complications.

Therefore,proper risk stratification and effective counseling beforeforwomen with CHD who are planning their pregnancies is an important undertaking.

 

Key words: Congenital heart disease pregnancy 

Abbreviations:  CHD, congenital heart disease; WHO, World Health Organization