Labor and Delivery with Cardiac Disease

Labor and Delivery with Cardiac Disease

In the Northwestern Medicine Heart Disease and Pregnancy Program maternal-fetal medicine (high-risk obstetrics), cardiology, and anesthesia specialists plan for problems that may occur during childbirth for women with heart disease. Your care team will decide how you deliver, vaginally or by cesarean section, based on the health of your pregnancy.

What to expect during labor and delivery

In general, women with heart disease who have done well during the pregnancy only need heart management with observation during labor and delivery. You may receive pain control and blood pressure monitoring. Women with cardiac symptoms and risk factors, such as high lung pressures or cardiac muscle disease, often need extra care. You may need oxygen and invasive hemodynamic monitoring during labor and delivery.

Your healthcare provider may have labor and delivery guidelines for you based on your underlying heart disease. Women with known heart disease may need to:

• Labor while lying on their left side. This keeps the uterus from resting on the inferior vena cava (large blood vessel that returns blood to the heart). When it is compressed by the uterus, blood flow back to the heart may be reduced. Decreased blood flow may cause the heart rate to increase.
• Take antibiotics before labor and delivery. This can prevent a heart infection.
• Have a shortened "pushing stage." This depends upon the nature of your heart disease.