When pregnancy occurs, a completely new period begins in woman’s life. This is a physiological process in which all organs and systems participate. A large load falls on the heart and blood vessels. An additional circle of blood circulation is formed – uterine-placental. In this regard, the volume of circulating blood increases, intra-abdominal pressure increases, and the position of the heart changes.
There are two main periods when the cardiovascular system undergoes the greatest changes.
The first period is in the period of 26-36 weeks of pregnancy, when the minute volume of the heart increases by 1.5 times, the cardiac output increases to the maximum, the pulse accelerates.
The second is the period of childbirth and the early postpartum period, when significant fluctuations in arterial and venous pressure occur, associated with cramps, exertion, and pain syndrome. Healthy women tolerate these changes well. Minor complaints of rapid heartbeat, shortness of breath, and dizziness may be observed. However, these symptoms pass on their own and do not require special treatment. In pregnant women who have cardiovascular diseases, the adaptation to the additional load on the heart is reduced and various complications may occur during pregnancy, childbirth and in the postpartum period.
Symptoms in which a pregnant woman should immediately consult a cardiologist:
- squeezing, pressing pains behind the sternum, which can spread to the left arm, under the shoulder blade, jaw;
- significant shortness of breath, which can occur both during physical exertion and at rest;
- swelling on the lower limbs;
- weakness, temperature increase;
- sharp fluctuations in blood pressure;
- fast, irregular heartbeat, as well as slow heartbeat, below 50 beats per minute.
HEART DISEASES AND THEIR INFLUENCE ON PREGNANCY
The most common heart diseases that can occur in pregnant women include:
- congenital heart defects; rheumatic heart diseases;
- idiopathic heart rhythm disorders;
- mitral valve prolapse and other manifestations of connective tissue dysplasia syndrome;
- cardiomyopathy;
- infectious endocarditis;
- coronary heart disease.
If any heart disease is detected during pregnancy, it is important to carefully monitor the pregnant woman by the treating cardiologist, closely cooperate with the obstetrician-gynecologist in preparation and for the further pregnancy management, surgical treatment according to the indications, and prescription of the necessary therapy. It is important to assess all the risks for the mother and child, choose the recommended type of delivery and the method of analgesia.
ARTERIAL HYPERTENSION AND PREGNANCY
Arterial hypertension, which is observed in 4-5% of pregnant women, plays a rather important role in complicating the course of pregnancy. Its presence is indicated by blood pressure exceeding 140/90 mmHg. With a significant increase in indicators more than 160/100 mmHg, there is a narrowing of the vessels of the placenta, which negatively affects the transfer of oxygen and all nutrients to the child, which can cause a delay in the development of the fetus, a lag in its weight, and even provoke a threat of termination of pregnancy. Therefore, it is very important to control and maintain blood pressure indicators within normal limits.
The risk group for hypertension includes:
- women who have previously been diagnosed with diseases of the kidneys, heart, and blood vessels;
- overweight women;
- women with endocrine diseases, pathology of the thyroid gland;
- women younger than 20 or older than 40;
- women with multiple pregnancies, especially if previously high blood pressure levels were noted.
PREVENTION OF CARDIOVASCULAR DISEASES BEFORE PREGNANCY
The most important thing is that the issue of admissibility of pregnancy and childbirth for a woman suffering from cardiovascular diseases should be decided in advance.
Therefore, prevention and preparation of women for pregnancy includes:
- Comprehensive examination of a cardiologist, therapist, family doctor, obstetrician-gynecologist. Conducting an electrocardiogram, ultrasound of the heart and other additional examinations for the purpose of early detection of cardiovascular diseases.
- Timely surgical correction of heart defects according to indications.
- Selection of individual medical treatment.
- Sanitation of foci of chronic infection (treatment of caries, ENT diseases, etc.).
- Normalization of body mass index (norm 19-24 for women).
- Dosed physical activity according to the doctor's recommendations.
In the presence of any diseases, preparation for pregnancy becomes especially necessary. Preventive examinations by a cardiologist and other specialists are always important to ensure the health of yourself and your child.
Author of the article: Yuliia Bartkiv, cardiologist of MDC “Med-Atlant”.
