Although cardiovascular disease is the leading cause of death in the United States, it has not been widely recognized that many types of heart disease can and do affect women of childbearing age. But that is rapidly changing.
"There is a growing awareness that during pregnancy, cardiac conditions can pose a danger to both mother and baby," says Loryn Feinberg, MD, Director of https://www.bidmc.org/centers-and-departments/obstetrics-and-gynecology/pregnancy/high-risk-pregnancy-maternal-fetal-medicine " in="" israel="" maternal="" medical="" of="" s="" specialists="" with="">Department of Anesthesia, Feinberg and colleagues in the Women's Cardiovascular Health program provide a highly specialized treatment approach for women with underlying cardiovascular issues who want to become pregnant as well as for women who develop cardiac problems during pregnancy. "By working together, we can identify potential problems and carefully coordinate care before, during and after a woman's pregnancy and delivery," says Feinberg. Before pregnancy: Have a preconception evaluation
For many patients, cardiac care begins before conception.
"A preconception cardiac evaluation is always recommended for women with underlying cardiovascular disease of any type," says Feinberg. Women who were born with congenital heart defects or have valve disease, coronary artery disease, as well as women who have arrhythmias or heart failure, should schedule an appointment for a cardiac evaluation before they become pregnant.
This comprehensive evaluation may include genetic assessment and evaluation of a woman's exercise capacity, as well as risk assessments for both mother and fetus. In addition, specific cardiac testing may be included.
Women who are becoming pregnant at later ages as well as women with a family history of heart disease or underlying risk factors can also benefit from a preconception evaluation.
"The average age of first-time mothers has steadily risen over the past several decades," says Melissa Spiel, DO, a Maternal and Fetal Medicine specialist at BIDMC who treats women with high-risk pregnancies . "With age comes a higher risk of heart complications, especially when compounded by preexisting conditions such as hypertension, diabetes and obesity. These may lead to a number of pregnancy complications, including a dangerous condition called preeclampsia." Related Stories
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