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Heart Valve Disease and Pregnancy

Topic Overview

Women who have a heart valve disease and want to become pregnant have some special considerations. A valve disease may increase the risk to the mother and the developing baby (fetus). Treatment of a valve disease might have to change during a pregnancy.

How much a heart valve disease increases risks during pregnancy depends on the type of valve disease and how bad it is.

If you have a heart valve disease and are considering pregnancy, talk with your doctors. You can get more information about your individual risk factors and treatment needs before and after pregnancy.

Heart valve diseases

Heart valve problems that may increase the risk of problems during pregnancy include:

Risks during pregnancy

If you have a mild or moderate form of valve disease, and if your heart is pumping blood normally, you can likely have a normal pregnancy with careful medical supervision. Simple practices such as getting plenty of bed rest and avoiding lying on your back can play important roles in successfully managing your pregnancy. You might also take medicines during pregnancy.

If you have more severe valve disease, you have a higher risk of problems during pregnancy. Your doctors may suggest that you consider surgery before you get pregnant. This might include a procedure to widen the valve or surgery to repair or replace the valve.

Artificial valves and blood thinners

You already have a replaced valve, and you take warfarin. Talk with your doctor if you plan on getting pregnant. You likely will not take warfarin if you are trying to get pregnant, because it can cause miscarriage or birth defects. You and your doctor will decide what blood thinner you will take while you are trying to get pregnant. You might take heparin during your pregnancy.

You are thinking about having a heart valve replaced before you get pregnant. You will have a choice of the type of heart valve you will get. The heart valve type you choose may depend on whether you plan to get pregnant in the future.

  • Your valve can be replaced with either a mechanical or tissue valve.
  • If you get a mechanical valve, you will need to take warfarin for the rest of your life. But you cannot take warfarin for at least the first trimester of your pregnancy. You will work with your doctor to choose an anticoagulant (such as heparin) that is safe for you to use during pregnancy.
  • If you get a tissue valve, you don't have to take anticoagulants long-term. But tissue valves don't last as long as mechanical valves. So you will need another surgery sooner than if you get a mechanical valve.

Treatment for heart valve disease during pregnancy

Treatments for a valve problem during pregnancy depend on the type of valve problem and how bad it is.

Medicine choices might include medicines that flush excess fluid out of the body (diuretics) and medicines to relax and expand the blood vessels.

A procedure that widens a heart valve might be done during pregnancy if the woman develops symptoms. This procedure, called a balloon valvuloplasty or valvotomy, is done for diseases that cause a heart valve to narrow (aortic valve stenosis and mitral valve stenosis). After the woman delivers, she may then have valve repair or replacement surgery.

References

Other Works Consulted

  • Nishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.

Credits

ByHealthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer David C. Stuesse, MD - Cardiac and Thoracic Surgery

Current as ofAugust 8, 2014

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