Heart Disease in Pregnancy

Abstract

Pregnancy imposes a significant and predictable circulatory burden which reaches a peak late in the second trimester. Heart failure is the major cause of maternal death in cardiac subjects, and the onset of decompensation and time of death are related to the hemodynamic burden of pregnancy. Supportive care, cardiovascular surgery, and therapeutic abortion are used in managing heart disease complicating pregnancy. Each plays a definite role, and none is a panacea. Pregnancy does not increase the risks of cardiac surgery, and antepartum operations on the heart do not jeopardize the baby. Generally, maternal cardiac disease does not by itself affect the incidence of spontaneous abortion or premature labor, the duration of labor, or the blood loss at delivery. Except in certain specific conditions, heart disease is not an acceptable indication for hysterectomy, hysterotomy, induction of labor, or cesarean section.