Congenital Heart Disease and Pregnancy

Most women with congenital heart disease (CHD) can expect to have a healthy and successful pregnancy. However, because pregnancy puts extra stress on the heart, careful evaluation and surveillance is essential.

Our program is dedicated to ensuring the best pregnancy outcomes for patients with congenital heart conditions.

Comprehensive Assessment

Our pre-pregnancy assessment helps you better understand the potential impact of pregnancy on your health and the potential risks to your unborn baby. This assessment includes:

A physical exam
An assessment of your cardiac reserve
An electrocardiogram—a test that records electrical activity of the heart and identifies rhythm abnormalities
An echocardiogram—an ultrasound test that uses high-frequency sound waves to view the heart and helps diagnose heart problems
Genetic testing—screening that helps CHD patients understand the possible risks to other family members

Our approach is unique because we provide a comprehensive look at your heart’s ability to work harder during strenuous physical activity. This helps us understand the risk for both mother and fetus.

Our experts collaborate easily with specialists in a variety of related fields to ensure the best possible patient care.

High-Risk Pregnancies

When high-risk patients become pregnant, our team works closely with referring obstetricians to monitor the patient and baby closely.

In the event that problems occur, our specialists draw on the extensive resources available through the Fetal Heart Program and the Cincinnati Children’s Fetal Care Center.

Already Pregnant?

If you are already pregnant, we offer assessments to evaluate the heart’s condition, your potential risk and the specific needs of your unborn baby.

Our team keeps in close communication with your obstetrician to ensure the best possible care. If the pregnancy is considered high-risk, we can help coordinate care during pregnancy and after the baby is born.

Frequently Asked Questions

Experts from the Adult Congenital Heart Disease Program at Cincinnati Children’s provide answers to frequently asked questions about adult congenital heart disease and pregnancy.

How does my heart change during pregnancy? Show: During pregnancy, your body makes more blood for the growing baby. Your body adjusts; the heart gets bigger and pumps faster and harder. If you have a congenital heart defect, pregnancy may strain your heart and cause it not to function as well.
As your heart gets ready for delivery, additional hormones are released that make the heart pump stronger. These hormones can also make your heart have irregular or fast heartbeats.
Also, your body prepares for delivery by making it easier for your blood to clot. Some women with congenital heart disease develop blood clots in their circulation systems more easily than others. Medications can help manage this.
What can I do to ensure a healthy pregnancy? Show: The basic rules of health also apply for pregnancy: Eat a healthy diet, do not smoke and get enough sleep. It is important to carefully consider the baby’s risks in addition to your own risks.
If you have congenital heart disease, you need to meet with a CHD specialist to make sure your heart is healthy enough to handle a pregnancy. Some women may need a procedure before they get pregnant to help protect their health.
What are the risk categories for women with a CHD? Show: Low risk: A woman born with a hole in the heart that was repaired, like atrial or ventricular septal defects
Medium risk: A woman born with Tetralogy of Fallot or transposition of the great arteries that was repaired
High risk: A woman with heart failure problems going into pregnancy, severe aortic stenosis, pulmonary hypertension, cyanosis or aortic aneurysms
How will you know if everything is on track through my pregnancy? Show: Our specialists monitor how your heart looks and how you feel throughout your pregnancy to make sure everything is OK. If there’s a problem, we can detect and treat it as early as possible. We plan ahead to ensure experts are available to care for you and your baby. We regularly work with specialists such as obstetricians, surgeons and anesthesiologists.
What are the risks for my baby? Show: In a small number of cases (3-4%), a CHD may be passed to the baby. Sometimes, a baby may be affected by the mother’s heart condition. If the mother is unwell during pregnancy, her baby may be born early, be small at birth or be medically fragile.
Some medications taken by mothers may also affect their babies. It’s important to discuss all medications with your doctor.
What if I’ve already had a child with a congenital heart defect? Show: If you’ve had a prior child with a congenital heart defect, you should likely be offered a fetal echocardiogram in future pregnancies.
Some types of congenital heart defects are more likely to be associated with an underlying genetic condition.