Pregnancy in women with left-to-right cardiac shunts: Any risk?

Abstract

An unacceptably high incidence of maternal mortality and morbidity, often due to cardiovascular disease, has been recently identified in developed nations with a call to action to improve maternal health and outcomes for both mother and baby. To improve the health of women during pregnancy it is important to identify underlying cardiac lesions which could complicate the course of a pregnancy. Even lesions deemed “simple” such as left-to-right shunts due to septal defects and persistent fetal connections may have potential complications of which the healthcare provider should be aware. Women of childbearing age may have had repair of a congenital heart lesion in childhood and develop problems as an adult. Conversely, women coming under medical scrutiny during pregnancy may be newly diagnosed with a congenital heart lesion. Often this is a left-to-right shunt lesion which permits survival to adulthood without intervention. Although the literature is limited regarding cardiac complications during pregnancy, it is important to highlight potential problems and particularly the women who may benefit form preconception consultation.

Keywords

• Pregnancy
• Cardiovascular complications
• Adult congenital heart disease
• Septal defects
• Left-to-right cardiac shunt lesions