❤If You Have Heart Disease and Want to Get Pregnant Read This First
Pregnancy in women with heart disease should be planned not accidental.
Not every cardiac condition carries the same risk.
Some women can proceed safely with monitoring.
Others face significantly increased maternal morbidity and mortality.
Before conception, a structured cardiac evaluation is essential.
๐ Ask These Questions Before Trying to Conceive:
1️⃣ What is my ventricular function (EF)?
2️⃣ Is my condition stable or progressive?
3️⃣ What is my NYHA functional class?
4️⃣ What is my WHO pregnancy risk category?
5️⃣ Do I need optimization before pregnancy?
Hemodynamic changes during pregnancy increase cardiac output by up to 50%.
If cardiac reserve is limited, decompensation may occur especially in the second and third trimesters.
๐ Medication Review Is Critical
Some cardiac medications are contraindicated in pregnancy and must be stopped before conception:
⚠️ ACE inhibitors (e.g., enalapril, lisinopril)
⚠️ ARBs
⚠️ Sacubitril/valsartan
⚠️ Spironolactone
⚠️ Warfarin (especially in the first trimester)
⚠️ Certain statins
Others may be used with careful supervision:
✔️ Beta-blockers (labetalol, metoprolol preferred)
✔️ Low-dose aspirin when indicated
✔️ Low molecular weight heparin instead of warfarin
✔️ Selected diuretics in stable cases.
Medication adjustment should always occur before conception, not after a positive test.
๐จ Very High-Risk Conditions
Some conditions may carry extremely high maternal risk:
• Severe pulmonary hypertension
• Severe left ventricular dysfunction
• Advanced cardiomyopathy
• Severe symptomatic valvular stenosis.
In these cases, pregnancy may be strongly discouraged.
Pregnancy does not forgive poor planning.
Preconception counseling changes outcomes.
Risk stratification saves lives.
Because protecting the mother’s heart
means protecting two lives.
Dr Rabab Cares
Cardio-Obstetrics Awareness Series
#DrRababCares
#PreconceptionCare
#CardioObstetrics
#MaternalHealth
#HeartDiseaseInPregnancy
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