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Forum Name: Arrhythmias

Question: Congestive heart failure and pregnancy


 owen's mom - Fri Mar 04, 2005 10:17 pm

My name is Lauren. I had a baby boy on Februrary 5, 2005. I thought that i had Pnemonia. It turned out that I was having congestive heart failure. I was airlifted to a bigger hospital and from that time on for the next six weeks i was on a ventilator. While all of this was going on my son was diagnosed w PKU. I was advised that i must have a tubal ligation, that i would certainly die if i got pregnant again. I did it, six months later... I really wanted more children. I see women on tv now and hear of women on the internet w successful pregnancy's. I believe that I was misinformed and I am angry about this. I am certainly happy that I am alive and that my son is doing wonderfully on his low Phe diet but I cant help but wonder why they didnt have more empathy for my situation. Please help me, I really am having a hard time with this. Thank you.
 Dr. Yasser Mokhtar - Sat Mar 05, 2005 8:43 am

User avatar Dear Lauren,

i don' t think that there have been enough big studies yet to say which way to go in which patients.

But, patients who develop peripartum cardiomyopathy and have persistent left ventricle dysfunction, are at a very high risk of complication during pregnancy and even death as pregnancy and labor pose a very high burden on the heart and circulation to begin with and these patients actually develop further reduction in their ejection fraction during pregnancy which means that their condition becomes worse. So, these patients are strongly advised not to become pregnant.

About patients whose ejection fraction improves, it was found in a small study that around 50% of these patients have deterioration in their ejection fraction during subsequent pregnancies and developed heart failure but there were no deaths reported.

i am not aware to which group of the above two you belong because i don't have this information, but there is no need to be upset or angry, i think you can always have a second opinion at a bigger tertiary care referral center.

If you belong to the second group and you were seen by a cardiologist who thought that you might become pregnant and all the risks that pregnancy to you and to your baby were discussed and you agreed to become pregnant, you have to understand that it is not going to be an easy process and that you will have to be watched very closely and carefully by obstetricicans with expertise in high risk pregnancy and cardiologists who have managed pregnant patients with peripartum cardiomyopathy before. And if you live in a smallish kind of town, it is not going to be easy commuting back and forth. You have to think about everything in advance and put everything into consideration before you chose to have this huge step as every detail will help you pass through pregnancy safely hopefully.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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