Rheumatic Heart Disease and Its Impact on Childbearing: What You Need to Know

Rheumatic heart disease (RHD) itself typically does not interfere with a woman's ability to conceive or carry a pregnancy. In most cases, the condition does not pose a direct threat to fertility or early pregnancy. However, the situation becomes more complex when surgical interventions are involved, particularly those requiring long-term anticoagulation therapy.

Understanding Pregnancy Risks After Heart Surgery

For patients who have undergone heart valve surgery and require blood thinners, pregnancy can pose significant risks. The physiological changes during pregnancy, including increased blood volume and the potential for bleeding during childbirth, can be dangerous for women on anticoagulant medications. Therefore, doctors often advise against pregnancy in such cases due to the heightened risk of life-threatening complications.

Choosing the Right Valve: Mechanical vs. Biological

Young women with RHD who still plan to have children should carefully consider the type of valve used if replacement becomes necessary. Biological valves, which do not typically require lifelong anticoagulation, are often recommended over mechanical valves. This choice allows women to conceive and give birth with fewer medical restrictions and lower associated risks.

When Pregnancy Should Be Avoided

In certain scenarios, pregnancy may not be advisable at all. Women who have developed atrial fibrillation and have received mechanical heart valves face particularly high risks. The combination of anticoagulant therapy and the natural blood loss during childbirth can lead to severe complications, including stroke or excessive bleeding, which can endanger both the mother and the baby.

Planning Ahead for a Safe Pregnancy

For women with RHD who wish to become mothers, early planning and consultation with a cardiologist are essential. If valve replacement is not immediately necessary, it may be wise to delay surgery until after childbirth. This approach helps avoid the complex interplay between medication needs and the demands of pregnancy, ultimately leading to better health outcomes for both mother and child.