TUESDAY, June 11, 2019 (American Heart Association News) – Taking good care of your health, especially your heart, is important during pregnancy. But preconception care – the care you receive before you become pregnant – can be just as crucial for both mother and baby.
"There are demands placed on the heart during pregnancy," Dr. said. Maria Sophocles, an OB-GYN and medical director of Women & # 39; s Healthcare of Princeton in New Jersey. "Women who are considering pregnancy need to optimize their heart health before conception to prepare for it."
That is true for every woman who becomes pregnant. But good heart care prior to conception is especially important for those who have conditions such as obesity, diabetes, high blood pressure or familial hypercholesterolemia, an inherited condition that keeps cholesterol levels high and increases cardiovascular risk.
These conditions, Sophocles says, also put women at higher risk for pregnancy complications, from pre-ambulatory labor to a potentially fatal condition called pre-eclampsia, characterized by high blood pressure and protein in the urine. It can be harmful to the placenta and the kidneys, liver and brain of the mother.
"If you are a diabetic who becomes pregnant, you run a greater risk of complications," she said. "And it's an additive: if you're a diabetic and a smoker and have high blood pressure, each of those things makes it much harder for the heart to pump extra blood through your bloodstream."
Cardiovascular disease is now the leading cause of maternal death during pregnancy and postpartum period, which represents 26.5% of pregnancy-related deaths, according to the American College of Obstetrics and Gynecologists. Women of color and people with lower incomes experience the highest mortality rates.
In May, ACOG advised doctors on screening, diagnosing and treating heart diseases from prepregnancy to the postpartum period, emphasizing the need to assess women for heart disease before they become pregnant.
That does not mean that a woman with cardiovascular risk factors should not become pregnant, said Dr. Melinda Davis, assistant professor of cardiovascular medicine and part of a maternal heart team at the University of Michigan. But it does mean taking extra precautions.
"If a woman has medical conditions, she must ensure that they are optimized before pregnancy so that she can be in the best possible health and also aware of the potential risks that may arise for both mother and mother baby, "she said. .
Good preconceived heart care involves managing weight, cutting back on alcohol and not smoking, Sophocles said.
Weight should be managed by eating lots of fruits, vegetables, and fiber, and regular exercise, "even if it only runs for 20 minutes a day," Sophocles said. "The human body can be seamlessly adapted to pregnancy, but if you are out of shape or a smoker, you will struggle more with pregnancy-related changes in your cardiovascular health."
Women with heart conditions or cardiovascular risk factors should consult both a cardiologist and an OB-GYN before trying to conceive to find out what precautions to take, Davis said. For example, a woman at risk of preeclampsia may be advised to take baby aspirin or blood pressure lowering medication if she is not currently doing so.
It is also important to discuss with a healthcare provider which medications you use to ensure that they do not pose a risk to the fetus, she said.
Experts also mention the rising age of mothers who are first mothers as one factor in the increase in maternal mortality in the United States, where pregnant women have a higher risk of death than in any other industrialized country.
A growing number of women in the United States are waiting until they are thirty or even forty to have children.
"Women who are older at the time of pregnancy are more likely to have other medical conditions, such as high blood pressure or diabetes," Davis said.
Assessments of maternal deaths in Illinois and California found that 1 in 4 deaths could have been prevented. Davis was a co-author of a recent perspective article on the need for a new field of & # 39; cardio obstetrics & # 39; involving women with risky pregnancies, where their care is managed by a team that includes cardiology, maternal-fetal medicine, obstetrics, anesthesiology and nursing.
"If you have a heart condition, you must already be under the care of a cardiologist, and this pregnancy must be co-managed," Sophocles said. "Don't just check in with your OB-GYN and hope everything goes well."
American Heart Association News relates to heart and brain health. Not all of the opinions expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, you can send an e-mail (secured with e-mail)
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