How to deal with pregnancy complicated by heart disease

Heart disease is one of the health killers of modern humans. Heart disease is often sudden and invisible, and once a heart attack occurs, the mortality rate is very high. Pregnancy complicated with heart disease is one of the diseases that has become increasingly common in recent years, posing a great threat to the lives of pregnant women. How should women deal with pregnancy complicated with heart disease?

Pregnancy complicated by heart disease is a serious obstetric complication and one of the main causes of maternal mortality. Pregnancy complicated by heart disease ranks second among causes of maternal and infant mortality in my country, and ranks first among non-direct obstetric causes of death. The incidence rate in my country is about 1%.

Pre-pregnancy consultation

Pre-pregnancy counseling is necessary for patients with heart disease. The ability to tolerate pregnancy is comprehensively judged based on the type of heart disease, the severity of the disease, whether surgical correction is needed, the level of heart function and medical conditions.

1. Pregnancy is possible: Those with mild heart disease, heart function level I to II, no history of heart failure, and no other complications can become pregnant.

2. Not suitable for pregnancy: Women with severe heart disease, heart function level III to IV, history of heart failure, pulmonary hypertension, right-to-left shunt congenital heart disease, severe arrhythmias, active rheumatic fever, heart disease complicated by bacterial endocarditis, acute myocarditis, etc. are very likely to develop heart failure during pregnancy and are not suitable for pregnancy. People who are over 35 years old and have a long history of heart disease are very likely to develop heart failure and should not become pregnant.

Pregnancy

1. Decide whether to continue the pregnancy. Pregnant women with heart disease who are not suitable for pregnancy should undergo therapeutic abortion before 12 weeks of pregnancy.

When the pregnancy exceeds 12 weeks, termination of pregnancy requires a more complicated operation, which is no less risky than continuing the pregnancy and giving birth. Therefore, the patient should be closely monitored and heart failure should be actively prevented and treated to help him/her through pregnancy and delivery. For patients with refractory heart failure, in order to reduce the cardiac burden, they should cooperate with the internal medicine physician and perform cesarean section under close monitoring.

2. Regular prenatal examinations can detect early signs of heart failure. Before 20 weeks of pregnancy, antenatal check-ups should be performed every 2 weeks. After 20 weeks of pregnancy, especially after 32 weeks, the risk of heart failure increases, and prenatal examinations should be done once a week. If you find early signs of heart failure, you should be hospitalized immediately. Even if the pregnancy goes smoothly, the patient should be hospitalized for delivery at 36 to 38 weeks.