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Grown ups with congenital heart defects | GUCH

Listen to you heart

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Family planning

Heart defects and pregnancies

Before you become pregnant, you should be aware of how your heart defect can affect you or your unborn child. If you have a congenital heart defect or a heart defect caused by rheumatic fever, for example, you must take this into account when planning your pregnancy.

Usually, a heart defect does not necessarily speak against becoming pregnant.

However, there are cases where pregnancy is too high a risk for mother or child.

Are heart defects hereditary?

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If the mother has a congenital heart defect, there is a 5 to 6% risk that her child will also be born with a heart defect.

If the father has a congenital heart defect, the risk lies at around 2%.

The general risk is 0.8%.

However, this does not mean that the child will have the same heart defect as the parent.

Through various examinations such as stress tests or a comprehensive cardiovascular check, your cardiologist can determine whether you are able to carry a child to term.

The most important examination is an echocardiography (ultrasound examination of the heart), followed by a cardiac magnetic resonance tomography (MRT). A computed tomography (CT) or cardiac catheterization is performed only rarely.

These examinations serve as a basis for your cardiologist to advise you correctly. Your cardiologist should also examine you regularly during your pregnancy. Ideally, the cardiologist, gynaecologist and midwife should work closely together: The cardiologist looks after YOUR heart, while the gynaecologist and the midwife keep an eye on the development of YOUR child.

If you have a serious heart defect, you will probably be referred to the obstetrics department of a university hospital, where more options are available.

If you have a less serious heart defect, you will be well looked after in a smaller obstetrics clinic.

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Further information:

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A pregnancy changes the body. If you have a heart defect, you or your unborn child may suffer from these changes. However, because every heart is different, you should first find out what pregnancy means for you.

A pregnancy affects the whole body.
Not only does the belly grow, but it also releases more hormones that promote blood circulation and increase the pulse (or heart rate). The heart has to do much more work and pumps 50% more blood per minute through the body than before the pregnancy.

These changes are gradual.
It begins around the sixth week of pregnancy and increases steadily until the contractions and birth. At the time of birth, the strain can be twice as high as before the pregnancy. Respiratory rate and pulse rate increase as a result. In the middle of pregnancy the blood pressure drops. A large baby belly can exert pressure on the blood vessels (veins), which can cause the legs to swell (edema), for example.

Pregnancy also has an effect on breathing.
By the time the baby is born, air intake increases from 7.5 l to 11 l per minute. This increase occurs because the tissue needs more oxygen and more carbon dioxide must be expelled. The breathing frequency increases and the breaths become deeper. A pregnant woman can also breathe in larger amounts of air.

The cardiovascular system has to work even harder during the birth.
Blood pressure and pulse rate increase even more during the bearing down pains. The heart also beats faster and has to work harder. With each contraction, blood is pressed out of the uterus. Up to 0.5 l is returned to the bloodstream.

A vaginal birth is generally the most favourable and the gynaecologist can support the last phase of the birth with a suction cup, for example.

After the birth your body slowly returns to its normal state. Your circulation also returns to normal after about four weeks.

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If you are regularly taking medication, be sure to talk to your cardiologist before you get pregnant.

Some medication can damage the foetus or have other adverse effects. One example is Warfarin, which affects blood clotting. You might have to stop some medicines and switch to an alternative instead.

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It is not possible to generalise as to which risks of pregnancy occur with which heart defect, as these depend on the type of heart disease.

Previous operations and catheter interventions must also be taken into account. Mild heart defects such as a small atrial septal defect or ventricular septal defect usually mean only a very low risk for a pregnancy, whereas cyanotic heart defects represent a much higher risk.

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When it comes to choosing the best contraceptive, it is best to discuss this with your cardiologist and your gynaecologist.

The contraceptive pill is associated with a risk of blood clots, whereas contraceptives placed in the womb, such as the coil, can lead to a risk of endocarditis. A prophylaxis against infective endocarditis is necessary if this form of contraception is chosen.

There are two types of contraceptive pill: the conventional pill and the so-called "mini-pill".

There is only a risk of blood clots forming with the conventional pill. The mini-pill, on the other hand, has the disadvantage that it is less reliable in protecting against pregnancy and can lead to menstrual problems such as mid-cycle bleeding.

An overview of contraceptive methods can be found here:


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