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Caring for Two – Heart Health for You and Your Baby

by Joshua Stutzman, DO, FACOG

When you are pregnant, you probably notice the fatigue, shortness of breath, and light-headedness that can sometimes overcome you. Did you know that these symptoms are caused by changes in your heart and blood vessels?

To ensure your baby gets enough oxygen and nutrients, your heart and vessels undergo some changes that may require your heart to work harder and put stress on your body.

These changes include:

  • Increase in blood volume. During pregnancy, your blood volume increases by 40 to 50%, to provide nutrients to your growing baby.
  • Rising heart rate. Your heart rate may increase by 15 beats per minute during pregnancy.
  • Drop in blood pressure. Hormonal changes and your growing baby can cause your blood pressure to drop. Your doctor will check your blood pressure regularly to make sure it stays within a safe range.
  • Increased stress on your heart. The increase in blood volume makes your heart work harder, increasing output by 30 to 50%. 

These changes have common symptoms, such as fatigue, however in rare occasions, they can also lead to heart failure. Therefore, it’s important to talk to your doctor about any concerns you may have, especially if you have a pre-existing heart condition.

Moms With Existing Heart Conditions

If you are thinking about pregnancy or planning to become pregnant, it is important to talk to your doctor. Some heart disorders could put you and the baby at increased risk. 

If you have an existing heart condition and learn you are pregnant, you should talk to your doctor as you may need to take some extra precautions. Existing heart conditions, such as hypertension, valve disease, heart failure, arrhythmia, and poor heart function can cause complications. The mother’s health directly impacts the baby’s health and could put you both at risk.

If you have an existing condition, your OB/GYN and your cardiologist will work together to develop a treatment plan. A team approach is key to make sure that both mom and baby remain healthy throughout the pregnancy.

Heart Problems That Can Develop During Pregnancy

There are some rare, but life-threatening heart conditions that can develop during pregnancy. Once you are pregnant, the treatment involves keeping both mom and baby safe.

Just like in cases of existing heart conditions, your team of care providers will collaborate to ensure that both mom and baby remain healthy throughout the pregnancy. It is important that everyone knows the different treatment options available, and makes an informed decision about treatment.

  • Peripartum cardiomyopathy (PCM) – Although rare, PCM is heart failure that develops at the end of the pregnancy or soon after delivery. It can be difficult to diagnose because many of its symptoms, such as shortness of breath and swelling in the legs and feet, common in normal pregnancy.
  • Hypertension or high blood pressure – Nearly 8% of pregnant women develop high blood pressure in pregnancy. This is called gestational hypertension and can progress to more serious conditions like preeclampsia and eclampsia.
  • Heart murmur – Due to the increased blood volume, the heart may sound unusual during pregnancy. Murmurs often sound like a swishing noise and can be harmless, but should be monitored by your doctor.
  • Arrhythmia – During pregnancy, your hormones or the stress on your heart may cause an abnormal heartbeat — too fast, too slow, or irregular rhythm. You may not need treatment, but your doctor may run more tests to determine the cause or the source of the irregular heartbeats.

Heart Disease After the Baby is Born

The good news is after your baby is born, the stress on your heart will go away, and your heart may return to normal. Unfortunately, some conditions, such as preeclampsia or high blood pressure, can lead to heart and vascular problems later and put future pregnancies at risk. It is important to continue to follow-up with your doctors to monitor any symptoms and have open conversations with them about how you feel as some symptoms may be subtle, but serious.

Learn more about Maternity Care at UPMC.