title: Pre-pregnancy counseling for women with heart disease: A prospective study.
abstract: BACKGROUND
  Women with cardiac disease and their infants are at a greater risk of mortality and morbidity during pregnancy. Expert groups recommend preconception counseling (PCC) for all women with cardiac disease so they are made aware of these risks. We have run a specialist maternal cardiac clinic since 1996. The aim of this study was to evaluate the experience of women who have received PCC within an established multidisciplinary tertiary clinic and to establish their views regarding the counseling they received.
  
  
  METHODS
  Single centre prospective study using a patient questionnaire was given to women attending a specialist cardiac preconception counseling clinic from November 2015 to August 2016, with analysis of descriptive data and free text comments from the questionnaire responders.
  
  
  RESULTS
  40/65 returned patient questionnaires. Prior to the consultation fewer than half felt well informed regarding how their heart disease could impact upon pregnancy but a similar proportion felt nonetheless that they would be able to have a healthy pregnancy. Women reported two main areas of concerns, their own health (whether they would survive a pregnancy) and the health of their child. 15% of women reported that these concerns had prevented them from pursuing a pregnancy. Women reported high satisfaction rates with the clinic.
  
  
  CONCLUSIONS
  There is an increasing demand for PCC services for women with cardiac disease; our study is the first attempt to determine both the acceptability and the impact of PCC from the patient perspective. Patients reported a high level of satisfaction with the service provided.
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
authors.forename: M
authors.initials: M
authors.lastname: Cauldwell
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Steer
authors.affiliation: Adult Congenital Heart Centre, The National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
authors.forename: L
authors.initials: L
authors.lastname: Swan
authors.affiliation: Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, 369 Fulham Road, London Sw10 9NH, UK.
authors.forename: R R
authors.initials: RR
authors.lastname: Patel
authors.affiliation: Adult Congenital Heart Centre, The National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Gatzoulis
authors.affiliation: Adult Congenital Heart Centre, The National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
authors.forename: A
authors.initials: A
authors.lastname: Uebing
authors.affiliation: Academic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Johnson
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D016742:Preconception Care / Q000379:methods*; D011295:Prenatal Care / Q000379:methods / Q000523:psychology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D055815:Young Adult