Preconception Counseling for Women With Cardiac Disease

Opinion statementAll providers who care for reproductive-aged women with cardiac disease should assess these patients ’ desires and plans for pregnancy at every encounter. For those considering pregnancy, preconception counseling, often performed by a maternal-fetal medicine specialist, can help patients understand the potential implications of pregnancy on their health and estimate the risks of an adverse cardia c event prior to conceiving. There are cardiac conditions, such as pulmonary hypertension and aortic stenosis, in which pregnancy may be contraindicated given the high morbidity and mortality; there are tools available to help quantify a patient’s risk. Furthermore, some cardiac lesions may be inh erited, which may warrant parental testing or a discussion of strategies to reduce the risk of an affected child, such as the use of assisted reproductive technologies. Preconception counseling is also important to identify other maternal risk factors, such as obesity, hypertension, and tobacco use, which are associated with adverse pregnancy outcomes and develop a strategy to mitigate their potential risks, ideally before pregnancy. For women on medications for their heart disease or other comorbidities, a thorough review of these medications can potentially avoid an exposure to a teratogen d uring conception and pregnancy. Once pregnant, a patient’s obstetrical provider and cardiologist should work together to outline a plan to monitor a patient’s cardiac status a...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research