CONGENITAL HEART DISEASE AND PREGNANCY

Abstract

Congenital heart disease (CHD) refers to a “gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance” [1]. Congenital heart disease is the most common congenital anomaly and makes up approximately one-third of congenital defects [2]. Due to advanced surgical and medical therapy for CHD, more women with CHD are reaching childbearing age, representing a unique challenge to obstetric providers. With advances, women with CHD are more frequently reaching childbearing age and conceiving. Many women with CHD can have successful pregnancies, although there are a few conditions that represent significant maternal risk such that pregnancy is considered contraindicated. Appropriate obstetric care for women with CHD requires a knowledge of cardiac physiology in pregnancy, the anatomy of CHD and repaired CHD, and coordinated care from cardiology and maternal-fetal medicine specialists. This chapter reviews the most common forms of CHD in pregnancy, outlines preconception counseling, discusses the associated morbidity and mortality of each lesion, and reviews current recommendations for management of CHD in pregnancy.