title: Pregnancy in women with congenital heart disease.
abstract: Due to advances in paediatric congenital heart surgery, there are a growing number of women with congenital heart disease (CHD) reaching childbearing age. Pregnancy, however, is associated with haemodynamic stresses which can result in cardiac decompensation in women with CHD. Many women with CHD are aware of their cardiac condition prior to pregnancy, and preconception counselling is an important aspect of their care. Preconception counselling allows women to make informed pregnancy decisions, provides an opportunity for modifications of teratogenic medications and, when necessary, repair of cardiac lesions prior to pregnancy. Less commonly, the haemodynamic changes of pregnancy unmask a previously unrecognised heart lesion. In general, pregnancy outcomes are favourable for women with CHD, but there are some cardiac lesions that carry high risk for both the mother and the baby, and this group of women require care by an experienced multidisciplinary team. This review discusses preconception counselling including contraception, an approach to risk stratification and management recommendations in women with some common CHDs.
authors: Division of Maternal and Fetal Medicine, Department of Obstetrics & Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Canada.
authors: Rohan
authors: R
authors: D'Souza
authors: Division of Maternal and Fetal Medicine, Department of Obstetrics & Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Canada; Obstetric Medicine Program, Division of Cardiology, Department of Medicine, University of Toronto, Mount Sinai Hospital and University Health Network, Canada.
authors: Mathew
authors: M
authors: Sermer
authors: Division of Maternal and Fetal Medicine, Department of Obstetrics & Gynaecology, University of Toronto, Mount Sinai Hospital, Toronto, Canada; Obstetric Medicine Program, Division of Cardiology, Department of Medicine, University of Toronto, Mount Sinai Hospital and University Health Network, Canada.
authors: Candice K
authors: CK
authors: Silversides
keywords: Pregnancy; congenital heart disease; heart disease; preconception counselling