title: Case studies of the perceptions of women with high risk congenital heart disease successfully completing a pregnancy.
abstract: OBJECTIVE
  Women even with moderate to severe congenital heart disease (CHD) seek motherhood despite posing significant health risks to themselves and their infant. This study explored their motivations and perceptions and compared them to those of women with low risk CHD who conceived.
  
  
  METHODS
  Twenty women over 18 years with CHD who had a successful pregnancy were recruited, half of whom were identified as having a high risk cardiac abnormality. They completed a questionnaire and a semi-structured interview following which a thematic analysis was employed. Their medical records and clinical status were also reviewed and their current cardiac status graded by their attending cardiologist.
  
  
  RESULTS
  Women with high risk (moderate to severe) CHD (n=10) appeared to have similar motivations for conceiving as women with low-risk (mild) CHD (n=10). Their decision to conceive seemed based on their own and at times unrealistic perceptions of the consequences of their CHD.
  
  
  CONCLUSIONS
  Women with mild or more severe CHD had similar motivations to conceive tending to down play the seriousness of their CHD. Their drive for motherhood appeared to be stronger than the drive for self care. It behoves clinicians, both obstetricians and cardiologists caring for women with high risk CHD to be knowledgeable of the effects of the CHD on the pregnancy and the impact of the pregnancy on the cardiac status.
authors.affiliation: Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne.
authors.forename: Kylie
authors.initials: K
authors.lastname: Ngu
authors.affiliation: Health Professional Education and Educational Research, Monash University.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hay
authors.affiliation: Health Professional Education and Educational Research, Monash University; Monash Heart, Monash Medical Centre, Melbourne, Australia. Electronic address: samuel.menahem@monash.edu.
authors.forename: Samuel
authors.initials: S
authors.lastname: Menahem
mesh_terms: D000328:Adult; D002755:Choice Behavior; D005195:Family Relations; D005260:Female; D006040:Goals; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006330:Heart Defects, Congenital / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D009042:Motivation; D010465:Perception; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000523:psychology*; D018566:Pregnancy, High-Risk / Q000523:psychology*; D036301:Qualitative Research; D018570:Risk Assessment; D011795:Surveys and Questionnaires
keywords: Congenital heart disease; Motivations; Perceptions; Pregnancy; Risks