What to do with pregnancy complicated by heart disease, what are the dangers?
2022-03-30
How to deal with pregnancy complicated with heart disease
Heart failure is the leading cause of death among pregnant women and mothers with heart disease. For women of childbearing age with heart disease, pre-pregnancy counseling is required to clarify the type, extent and functional status of heart disease and to determine whether pregnancy is possible. Pregnant women should have regular antenatal checkups starting in the first trimester.
Methods of coping with pregnancy
Method 1: Deciding whether to continue the pregnancy: All pregnant women with cardiac disease who are not suitable for pregnancy should choose therapeutic abortion.
Method 2: Regular obstetric examinations: early signs of heart failure can be detected early. Checks should be performed every 2 weeks until 20 weeks of gestation. After 20 weeks of gestation, weekly obstetric examinations should be performed. If you notice early signs of heart failure, you should be hospitalized immediately. A successful pregnancy should also be hospitalized in advance for delivery at 36-38 weeks.
Method 3: Prevention and treatment of heart failure
A. Rest: Ensure adequate rest, sleep at least 10 hours a day, and avoid overwork and emotional agitation.
B. Diet: Limit excessive weight gain due to over-fortified nutrition.
C. Prevention and treatment of causes of heart failure: prevention of upper respiratory tract infection, correction of anemia, treatment of arrhythmia, prevention and treatment of pregnancy-induced hypertension.
D. Dynamic observation of cardiac function: B echocardiography is performed regularly to determine changes in cardiac function with increasing gestational age.
Methods of coping with childbirth
The mode of delivery of pregnant women with heart disease mainly depends on the state of cardiac function and obstetric conditions, and an appropriate mode of delivery should be selected in advance. It should be noted that routine prophylactic antibiotics are not recommended, regardless of the mode of delivery.
Method 1: vaginal delivery
Vaginal delivery is feasible in most cases and, in principle, can be performed if there are no obstetric complications in patients with cardiac function class I-II.
Method 2: Cesarean section
Indications for caesarean section for pregnancy with cardiac disease are: Obstetric indications such as placenta previa or fetal malformation, Marfan syndrome with dilated aortic root, aortic aneurysm at risk of dissection, cardiac surgery (depending on the fetus) in the following conditions Cesarean section should be selected under: gestational age), cardiac function class III-IV, active rheumatic fever, pulmonary hypertension or pulmonary congestion, and coarctation of the aorta. Preoperative, intraoperative, and postoperative cardiac electrocardiogram monitoring, blood oxygen saturation monitoring, and postoperative anti-infection are all indispensable and important measures to ensure surgical safety.
Methods to deal with the puerperium
Principles: infection prevention, breastfeeding problems, contraception, etc.
(1) Close monitoring: close monitoring is required within 24-48 hours after delivery, because this is still a dangerous period for heart failure, and the difference needs to be fully rested and closely monitored.
(2) Prevention of postpartum complications: Postpartum hemorrhage, pulmonary edema, and thromboembolism are serious complications that easily induce heart failure and should be prevented. Once a large amount of bleeding is found, it should be actively dealt with. If necessary, hemostatic drugs, blood products or plasma can be used, and the uterus should be removed if necessary.
(3) Maternal heart function grade III and above, and do not breastfeed after delivery. For those who are not suitable for childbirth, it is recommended to perform ligation surgery about 1 week after delivery.
(4) Personalized psychological care: New mothers suffering from heart disease, especially premature babies, are prone to anxiety. At this time, the medical staff should help the mother to eliminate adverse psychological factors, reduce the psychological burden, guide the mother to maintain a good psychological state, and inform the family at the same time. You should spend more time with your mother to help regulate her emotions.
Influence of pregnancy complicated with heart disease
Harm of pregnancy complicated with heart disease to pregnant women
Pregnancy, childbirth, and puerperium increase the burden on the heart of pregnant women with heart disease, induce heart failure, and lead to maternal death.
The harm of pregnancy complicated with heart disease to the fetus
The impact of pregnancy with heart disease on the fetus is related to the severity of the disease and cardiac function.
Hazard 1: Expectant mothers with mild illness and good compensatory function, the fetus is relatively safe, and there are many opportunities for cesarean section.
Hazard 2: The incidence of miscarriage, premature birth, stillbirth, fetal growth restriction, fetal distress and neonatal asphyxia is significantly higher in those with poor cardiac function after pregnancy. The perinatal mortality rate is 2-3 times that of normal pregnancy.
Hazard 3: Drug effects: Some drugs for the treatment of heart disease also have potential toxic effects on the fetus. For example, digoxin can freely cross the placenta and reach the fetus.
Hazard 4: Inheritance of heart disease: Most congenital heart diseases are polygenic. If either parent has congenital heart disease, their offspring are 5 times more likely to have congenital heart disease and other types of offspring than the control group, such as ventricular septal defect, hypertrophic cardiomyopathy and other high heritability.
Heart failure is the leading cause of death among pregnant women and mothers with heart disease. For women of childbearing age with heart disease, pre-pregnancy counseling is required to clarify the type, extent and functional status of heart disease and to determine whether pregnancy is possible. Pregnant women should have regular antenatal checkups starting in the first trimester.
Methods of coping with pregnancy
Method 1: Deciding whether to continue the pregnancy: All pregnant women with cardiac disease who are not suitable for pregnancy should choose therapeutic abortion.
Method 2: Regular obstetric examinations: early signs of heart failure can be detected early. Checks should be performed every 2 weeks until 20 weeks of gestation. After 20 weeks of gestation, weekly obstetric examinations should be performed. If you notice early signs of heart failure, you should be hospitalized immediately. A successful pregnancy should also be hospitalized in advance for delivery at 36-38 weeks.
Method 3: Prevention and treatment of heart failure
A. Rest: Ensure adequate rest, sleep at least 10 hours a day, and avoid overwork and emotional agitation.
B. Diet: Limit excessive weight gain due to over-fortified nutrition.
C. Prevention and treatment of causes of heart failure: prevention of upper respiratory tract infection, correction of anemia, treatment of arrhythmia, prevention and treatment of pregnancy-induced hypertension.
D. Dynamic observation of cardiac function: B echocardiography is performed regularly to determine changes in cardiac function with increasing gestational age.
Methods of coping with childbirth
The mode of delivery of pregnant women with heart disease mainly depends on the state of cardiac function and obstetric conditions, and an appropriate mode of delivery should be selected in advance. It should be noted that routine prophylactic antibiotics are not recommended, regardless of the mode of delivery.
Method 1: vaginal delivery
Vaginal delivery is feasible in most cases and, in principle, can be performed if there are no obstetric complications in patients with cardiac function class I-II.
Method 2: Cesarean section
Indications for caesarean section for pregnancy with cardiac disease are: Obstetric indications such as placenta previa or fetal malformation, Marfan syndrome with dilated aortic root, aortic aneurysm at risk of dissection, cardiac surgery (depending on the fetus) in the following conditions Cesarean section should be selected under: gestational age), cardiac function class III-IV, active rheumatic fever, pulmonary hypertension or pulmonary congestion, and coarctation of the aorta. Preoperative, intraoperative, and postoperative cardiac electrocardiogram monitoring, blood oxygen saturation monitoring, and postoperative anti-infection are all indispensable and important measures to ensure surgical safety.
Methods to deal with the puerperium
Principles: infection prevention, breastfeeding problems, contraception, etc.
(1) Close monitoring: close monitoring is required within 24-48 hours after delivery, because this is still a dangerous period for heart failure, and the difference needs to be fully rested and closely monitored.
(2) Prevention of postpartum complications: Postpartum hemorrhage, pulmonary edema, and thromboembolism are serious complications that easily induce heart failure and should be prevented. Once a large amount of bleeding is found, it should be actively dealt with. If necessary, hemostatic drugs, blood products or plasma can be used, and the uterus should be removed if necessary.
(3) Maternal heart function grade III and above, and do not breastfeed after delivery. For those who are not suitable for childbirth, it is recommended to perform ligation surgery about 1 week after delivery.
(4) Personalized psychological care: New mothers suffering from heart disease, especially premature babies, are prone to anxiety. At this time, the medical staff should help the mother to eliminate adverse psychological factors, reduce the psychological burden, guide the mother to maintain a good psychological state, and inform the family at the same time. You should spend more time with your mother to help regulate her emotions.
Influence of pregnancy complicated with heart disease
Harm of pregnancy complicated with heart disease to pregnant women
Pregnancy, childbirth, and puerperium increase the burden on the heart of pregnant women with heart disease, induce heart failure, and lead to maternal death.
The harm of pregnancy complicated with heart disease to the fetus
The impact of pregnancy with heart disease on the fetus is related to the severity of the disease and cardiac function.
Hazard 1: Expectant mothers with mild illness and good compensatory function, the fetus is relatively safe, and there are many opportunities for cesarean section.
Hazard 2: The incidence of miscarriage, premature birth, stillbirth, fetal growth restriction, fetal distress and neonatal asphyxia is significantly higher in those with poor cardiac function after pregnancy. The perinatal mortality rate is 2-3 times that of normal pregnancy.
Hazard 3: Drug effects: Some drugs for the treatment of heart disease also have potential toxic effects on the fetus. For example, digoxin can freely cross the placenta and reach the fetus.
Hazard 4: Inheritance of heart disease: Most congenital heart diseases are polygenic. If either parent has congenital heart disease, their offspring are 5 times more likely to have congenital heart disease and other types of offspring than the control group, such as ventricular septal defect, hypertrophic cardiomyopathy and other high heritability.
