Topic Overview

Women who have a heart valve disease and want to become pregnant have some special considerations. A valve disease may increase the risk to the mother and the developing baby (fetus). Treatment of a valve disease might have to change during a pregnancy.

How much a heart valve disease increases risks during pregnancy depends on the type of valve disease and how bad it is.

If you have a heart valve disease and are considering pregnancy, talk with your doctors.

  • Think about talking with a genetic counsellor about the risk of passing a heart defect to your child.
  • Ask your doctor if being pregnant might cause any health problems. Your doctor will check your health and help you stay healthy during your pregnancy.

Heart valve diseases

Heart valve problems that may increase the risk of problems during pregnancy include:

Artificial valves and blood thinners

You already have a replaced valve, and you take warfarin. Talk with your doctor if you plan on getting pregnant. You likely will not take warfarin if you are trying to get pregnant, because it can cause miscarriage or birth defects. You and your doctor will decide what blood thinner you will take while you are trying to get pregnant. You might take heparin during your pregnancy.

You are thinking about having a heart valve replaced before you get pregnant. You will have a choice of the type of heart valve you will get. The heart valve type you choose may depend on whether you plan to get pregnant in the future.

  • Your valve can be replaced with either a mechanical or tissue valve.
  • If you get a mechanical valve, you will need to take warfarin, for the rest of your life. But you cannot take warfarin for at least the first trimester of your pregnancy. You will work with your doctor to choose an anticoagulant (such as heparin) that is safe for you to use during pregnancy.
  • If you get a tissue valve, you don't have to take anticoagulants long-term. But tissue valves don't last as long as mechanical valves. So you will need another surgery sooner than if you get a mechanical valve.

Treatment for heart valve disease during pregnancy

Treatments for a valve problem during pregnancy depend on the type of valve problem and how bad it is.

A procedure that widens a heart valve might be done during pregnancy if the woman develops symptoms. This procedure, called a balloon valvuloplasty or valvotomy, is done for diseases that cause a heart valve to narrow (aortic valve stenosis and mitral valve stenosis). After the woman delivers, she may then have valve repair or replacement surgery.

References

Other Works Consulted

  • Canobbio MM, et al. (2017). Management of pregnancy in patients with complex congenital heart defects: A scientific statement for healthcare professionals from the American Heart Association. Circulation, 135(8): e50-e87. DOI: 10.1161/CIR.0000000000000458. Accessed March 2, 2017.
  • Nishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.

Credits

ByHealthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Brian D. O'Brien, MD - Internal Medicine
Martin J. Gabica, MD - Family Medicine
Elizabeth T. Russo, MD - Internal Medicine
Specialist Medical Reviewer David C. Stuesse, MD - Cardiac and Thoracic Surgery
Michael P. Pignone, MD, MPH, FACP - Internal Medicine
Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology

Current as ofMay 31, 2017