Overview

Heart Disease and Pregnancy

Often women with cardiovascular (heart) disease are told that they should not get pregnant. But, in some cases, they can have a healthy pregnancy. It can be safe for both mother and baby. The Northwestern Medicine Heart Disease and Pregnancy Program at Bluhm Cardiovascular Institute has over 30 years of experience managing heart disease during pregnancy. This program provides specialized care for pregnant women with heart disease. The goal is a successful outcome for both mother and baby.

The Heart Disease and Pregnancy Program takes a multidisciplinary approach. Specialists from Maternal-Fetal Medicine (high-risk Obstetrics), anesthesia, obstetrics, cardiac genetics, and other areas work together to care for pregnant women with heart disease. Women who benefit from this program include:

• Women born with heart disease
• Women who develop heart disease before pregnancy
• Women who develop heart disease during pregnancy

How pregnancy affects the heart

During pregnancy, the mother's circulatory system changes. Her blood volume increases because the circulatory system provides blood to the uterus and placenta. The plasma (fluid in the blood) volume increases faster than the blood cells. This results in anemia (lower than normal number of red blood cells), which may increase demands on the heart. The plasma volume increase starts early in pregnancy and peaks between 24 and 26 weeks. A pregnant woman’s plasma level goes up by about 50% compared to when she is not pregnant.

Later in pregnancy, the heart rate increases to circulate blood to the uterus. A mother’s heart rate is highest in the last trimester. The heart rate may increase by 10 to 20%. But, a pregnant woman may not feel this change. The total cardiac output (volume of blood pumped out of the heart with each beat) increases by up to 50% in mid-pregnancy. It is also normal during pregnancy for the blood vessels to dilate. This causes blood pressure to fall.