Around 8 in 1,000 babies are born with something wrong with their heart. This can sometimes be called a cardiac abnormality, congenital heart disease or congenital heart defect.
If you were born with a cardiac abnormality and have had a successful operation to correct it, you'll probably have some scarring of the heart. This may make you more prone to infections or an irregular heartbeat.
If you have heart disease you may be able to have a successful pregnancy, but pregnancy puts your heart under significant strain. This can lead to problems, so talk to your doctor before you get pregnant or as soon as you know you're pregnant.
See a heart specialist (cardiologist)
If you were born with a heart problem and you're planning to have a baby, talk to your cardiologist before you get pregnant.
If you were treated for congenital heart disease as a baby or a child, you may not have seen a heart specialist for many years. So getting regular checks if you're planning a pregnancy, or are pregnant, is important.
If you do not have a cardiologist, ask a GP to refer you to one.
Your doctor can talk with you about:
- any medicine you're taking and whether this may need adjusting in pregnancy
- how your heart condition might affect your pregnancy
- how pregnancy might affect your heart condition
Do not stop taking your medicine without speaking to your doctor.
Your care in pregnancy
You'll be referred to a hospital maternity unit for team-based care (the team will include a cardiologist, obstetrician and midwife).
You may be able to attend a special cardiac pregnancy clinic if there's one in your area. Ask your GP for details or contact the Somerville Heart Foundation – a charity for grown-up congenital heart disease patients.
A congenital heart disease cardiologist will assess you and plan your care with you. It's hard to predict the effect of congenital heart disease on your pregnancy because each case is different.
The only way to estimate your risk and to determine what complications, if any, you might have during pregnancy is to have a careful assessment by a specialist.
It's important to know what problems could arise. Depending on what type of congenital heart disease you have, you may develop fluid on the lungs, heart failure or arrythmia (an irregular and/or fast heartbeat).
Your baby
Your congenital heart disease can affect your baby. Your baby may be smaller if your heart does not pump as efficiently as it should and delivers less oxygen and nutrients to the placenta and your developing baby.
Babies may be born prematurely. You'll be offered regular scans during pregnancy to ensure that your baby is growing normally and healthily.
Depending on the type of congenital heart disease you have, there's a chance that your baby could inherit the condition. For example, if you have Marfan syndrome there's a 1 in 2 chance your baby could inherit the condition.
If there's a chance your baby could inherit your condition, you'll be referred to a specialist who can give you advice.
The British Heart Foundation has information for parents on coping with a child's congenital heart disease.
You need to know as much as you can about your condition, so your baby can get special care if necessary when they are born.
Many, but not all, conditions in an unborn baby can be detected during pregnancy. The future management of your pregnancy and care of your baby will be discussed with you, and a specialist children's heart doctor (cardiac paediatrician) will advise you on the options available once your baby is born.
Treatment and self-management
The treatment you receive will depend on what condition you have. Your cardiologist will provide you with a tailored antenatal care plan.
This may mean that you have to change the medicines you take. For example, ACE inhibitors (a group of medicines used to treat heart failure) are not recommended during pregnancy. Your specialist will discuss this with you.
Do not stop taking your medicine without talking to your specialist first.
During your pregnancy, follow any advice your specialist gives you about managing your condition. Low-impact exercise, such as swimming and walking, is usually a good idea to keep you fit, but always speak to your midwife or doctor before starting any new exercise programme.
Labour and birth
Discuss your options for where you can give birth with your healthcare team. This should include a cardiologist with experience in treating congenital heart disease in pregnancy.
You may be advised to give birth in hospital and you’ll have an individual birth plan.
Depending on the type and severity of heart disease, inducing labour may not be recommended because of the effect the medicines used may have on the heart.
It's usually best to wait for spontaneous labour (labour that starts naturally), unless the baby has to be delivered early because it is safer for you or your baby.
You will not be automatically advised to have a caesarean section because you have congenital heart disease. This will depend on the type and severity of your heart disease. Your healthcare team will discuss all your options with you.
However, it may be recommended that you have a pain-free labour, which means that you may have an epidural, and your doctor may use forceps or a vacuum delivery (ventouse) to assist you during the delivery, as this avoids the strain of having to push the baby out.