By Julie Vargo, Editorial Contributor
When pregnant, a woman’s body undergoes dramatic changes. Some, like swollen feet and protruding stomachs, are obvious. But changes to the heart and blood vessels? You can’t see them, but they’re happening too.
Blood volume increases 40 to 50 percent.
The amount of blood pumped by the heart each minute jumps 30 to 40 percent.
Heart rate increases 10 to 15 beats per minute.
And blood pressure drops.
While all normal, these changes put additional stress on the body and require the heart to work harder, says Dr. Sushma Koneru with the Orlando Health Heart & Vascular Institute. They also can cause fatigue, shortness of breath and light-headedness.
Heart of the Matter
Typically, gestational stress on the heart clears up with the baby’s birth. By three months postpartum, a new mother’s cardiovascular system generally has snapped back to pre-pregnancy status.
For some women, however, pregnancy introduces a bevy of abnormal cardiac conditions demanding medical intervention. “Being pregnant can make other cardiac problems worse, create new problems or help a woman discover underlying heart issues not previously diagnosed,” says Dr. Koneru, a board-certified noninvasive cardiologist and heart failure specialist.
During pregnancy, women are more prone to blood clots due to hormonal changes. Spontaneous tears in the aorta, high blood pressure, preeclampsia, cardiomyopathy, heart failure, gestational diabetes, heart murmurs, preterm labor and valve problems also can occur.
Cardiac disease during pregnancy can present challenges and potentially increase the risk of complications. Only 6 percent of women who suffer a pregnancy-related death due to heart disease, says Dr. Koneru, were diagnosed with a previous heart condition.
What’s a Mother To Do?
“When you suffer a cardiac disorder while pregnant, it is important to see both a high-risk OB-GYN and a cardiologist during your pregnancy and after you give birth,” says Dr. Koneru.
Some conditions — like preeclampsia and gestational diabetes — clear up after birth. Unbeknownst to most new mothers, these issues may resurface later in life.
“Women who suffer these conditions during pregnancy are more prone to developing stroke, high blood pressure and heart attacks in the future,” says Dr. Koneru. “The condition goes away after delivery, and the new mothers go home with their babies. Rarely does anyone talk to them about heart disease.”
They should. A mother who suffers gestational diabetes while pregnant may get diabetes later in life. Delivering a preterm baby puts a mother at increased risk for future heart attacks and stroke. Preeclampsia, or high blood pressure, during pregnancy doubles a woman’s chance of developing heart disease five to 15 years postpartum.
Women with an underlying or known cardiac condition need to take special precautions before and during pregnancy. “If you have heart disease, it’s vital to talk to a cardiologist before becoming pregnant to discuss the short- and long-term risks,” says Dr. Koneru. “Not all heart medications are safe to take during pregnancy. If new symptoms surface during pregnancy, a doctor needs to know. “
New Heart Disease and Pregnancy Program
To address cardiac conditions in mothers-to-be, Orlando Health has created the Heart Disease and Pregnancy Program. Designed to provide specialized, appropriate care for pregnant women with heart disease, the innovative program takes a multidisciplinary approach to maternal heart health.
Specialists from maternal-fetal medicine, anesthesia, obstetrics, cardiology and other subspecialties collaborate to provide comprehensive care for pregnant women with heart disease.
“This program was created to benefit women born with heart disease, those who acquire heart disease prior to their childbearing years and those who develop heart disease during pregnancy,” says Dr. Koneru. “The goal is a successful outcome for both mother and baby.”