What to do

  • Women with cardiac disease should be managed in a tertiary centre by a team consisting of a cardiologist, obstetrician, anaesthetist and neonatologist.
  • Thorough clinical examination is required at the first visit.
  • When you are diagnosed with any cardiac disease prior to pregnancy and confirmed with pregnancy test report to hospital as early as possible to evaluate your nature of heart disease and the general condition.
  • Medications should be reviewed to make sure that they are safe in pregnancy.
  • The mother will be counselled regarding lifestyle changes and warning signs and symptoms depending on the nature of the heart disease.

Warning symptoms

  • Dyspnoea on even mild activity/ rest
  • Orthopnoea
  • Paroxysmal nocturnal Dyspnoea
  • Haemoptysis
  • Chest pain
  • Palpitations
  • Counselling about maternal risks, foetal complications, risk of congenital heart disease in foetus to be discussed.
  • All pregnant women are advised to do ECG, ECHO as a part of the investigation to identify the structural and functional status of the heart.
  • Pregnancy is contraindicated in certain heart disease. So, before planning your pregnancy or in early pregnancy it is essential to discuss with the cardiologist regarding the potential health risk for mother and the baby.
  • When you have associated anaemia, hypertension, respiratory infection and asymptomatic bacteriuria it should be managed promptly.
  • You will be monitored closely during antenatal period only when you have a regular check-up in tertiary care centre by which doctors will be well aware of your records.
  • Antibiotic prophylaxis will be given at the time of delivery.
  • Postpartum period is equally important in managing the patient with heart disease. Close monitoring should continue for 24hrs after delivery in intensive care unit to avoid complications.
  • There is high risk for postpartum bleeding, sepsis and thromboembolism in postpartum period it is to be managed accordingly.
  • Cardiac status to be reassessed in after 6 weeks even after discharge from the hospital.
  • It may take up to 6 months for cardiac status to return to normal.