Pregnancy for heart defects
Among diseases that are not related to the reproductive system, in the pregnant women most often there are diseases of the cardiovascular system, in particular - heart diseases. However, thanks to the achievements of modern medicine and they have a chance to bear and give birth to a healthy child.
It is common to call a heart disease a violation of the valves of this organ. The valve is a fold that closes the opening between the chambers and ensures the flow of blood in the right direction. A pathological condition, or heart disease, occurs when the valve is inadequate or narrowed.
If the is insufficient, the sashes do not close completely, leaving the passage open. And part of the blood returns back against its current, stretching the walls of the chambers.
When narrowing , an obstacle is created to the blood flow, and the heart is forced to exert more effort.
When stenosis and insufficiency develop on the same valve, they speak of a combined heart disease. Sometimes the pathological process affects several valves - the so-called combined defect.
With heart defects, the heart is not able to perform its function adequately. Especially it is dangerous for a pregnant woman, when the load on the heart increases. Heart defects are congenital and acquired. The first, as it is clear from the title, children receive even at the time of intrauterine development. If a woman has such a defect, during her pregnancy, a thorough examination in a specialized hospital by a therapist, a cardiosurgeon and an obstetrician-gynecologist is necessary. If there is still a lack of blood circulation, then, most likely, will recommend an abortion. Having a congenital heart disease, a woman should know about the possible risk and prepare for the planned pregnancy, constantly consulting with a doctor. Acquired heart defects in 90% of cases are formed against the background of rheumatic fever. They can occur both before and during pregnancy. The most common defect is mit-
ral stenosis - narrowing of the opening of the valvular heart valve. Women who suffer from rheumatism, it is very important to plan pregnancy. The doctor will help you choose the optimal time for conception of the child, identify the degree of risk, decide on the possibility of continuing the bearing of the child. Perhaps relatively favorable during pregnancy, if the rheumatic process is not active, there are no significant disorders of blood circulation, and the correct treatment is being conducted.
Examination of a future mother with heart disease should include ultrasound of the heart( echocardiography), ECG( electrocardiography), dopplerography. These methods are harmless, they will not harm a woman's health and her baby. The correct schedule of the examination is prescribed by the doctor.
Relatively well tolerate pregnancy and childbirth with appropriate treatment, suffering from such defects as interatrial or interventricular septal defect, nevroschenie arterial duct. With some vices( stenosis of the pulmonary artery mouth, tetralogy of Fallot, coarctation of the aorta, etc.), pregnancy is strictly contraindicated because of the development of significant disorders in the circulatory system and can lead to the death of a woman.
Throughout the waiting period of the child, women with heart defects are treated with medication. It helps to ensure normal blood circulation, create conditions for the proper development of the fetus. The physician determines the choice of the means and dosages of treatment in the
depending on the severity of the disease, the gestational age. The main drugs: cardiac glycosides, vasodilators, antiarrhythmic drugs, diuretics, antiaggregants and anticoagulants.
During pregnancy, a woman should apply at least three times to a cardiological hospital for a preventive examination:
1) for up to 12 weeks - to decide on the possibility of maintaining a pregnancy;
2) in the period from 28th to 32nd week - to identify and prevent the development of possible complications;
3) 2 weeks before the birth - in order to prepare for them.
When congenital heart disease should also be remembered that it can be transmitted by inheritance, when planning a child in this case it is necessary to visit also a genetic consultation.
The way a woman with heart disease will give birth is decided individually. Natural births are possible. However, a cesarean section is often performed. This operation is performed in the following cases:
1) if heart disease is combined with obstetric pathology: narrow pelvis, abnormal fetal position in the uterus, placenta previa, etc.;
2) in heart disease with severe circulatory disturbances with insufficient effect of drug treatment;
3) with active rheumatic process.
In some cases, at the end of pregnancy, there is a sharp increase in the burden on the heart, while the condition of a woman is significantly worsened and the continuation of the child's bearing can be dangerous for her. Then, an early delivery may be required. It is better to spend it on a period of 37-38 weeks.
Follow-up of a young mother and treatment continue after delivery. Prescribe drugs that improve the activity of the heart.