Pregnancy brings with it a number of changes which include the deploying of extra resources toward the development of a fetus, although the heart is the one that takes the most of the workload. These changes are necessary to support the increased demands of both the mother and the developing fetus. It is essential therefore to elaborate on how the heart operates in respective pregnancy, what can be done for commonly occurring problems, and try to put into light some of the recent developments in management and monitoring of the heart during this extremely essential phase of life of an expected mother. Dr. Madhu Juneja, Director – obstetrician, gynecologist and IVF at Sahyadri Hospitals Momstory, Hadapsar Annexe in Pune shares the changes in heart and how pregnancy can affect heart health along with precautions.
Physiological changes that affect the heart during pregnancy
Dr. Juneja says during the antenatal period the expecting mother experiences several cardiovascular changes to accommodate the developing fetus.
Increased blood volume: Weight gain is one of first changes in the body during pregnancy which is accompanied by an increase in blood volume. Though, this physiological change is essential to meet the fetus’s metabolic requirement, one of the implications of the increased blood volume is increased workload on the heart muscle and there is an increase in cardiac output by 30-50% – a process which determines how much the heart beats in a minute.
- Heart rate changes: The heart rate typically increases by 10-20 beats per minute during pregnancy. This tachycardia (increased heart rate) begins in the first trimester and peaks during the second trimester.
- Structural changes: There are also slight changes in the structure of the heart, including hypertrophy (thickening) of the heart muscle and a slight increase in the size of the chambers. The heart becomes large and deviates to left side
- Common cardiovascular issues during pregnancy - Several cardiovascular conditions can either arise or be exacerbated during pregnancy:
- Gestational Hypertension: This is high blood pressure that develops after week 20 of pregnancy and usually resolves after delivery. High blood pressure can impact on underlying cardiac condition.
- Preeclampsia: Characterised by high blood pressure and signs of damage to another organ system, often the kidneys. Preeclampsia can lead to serious or even fatal complications for both mother and baby if unmanaged.
- Peripartum cardiomyopathy: This rare form of heart failure occurs during the last month of pregnancy or up to five months after giving birth. The heart becomes enlarged and weakened, unable to pump blood efficiently.
- Arrhythmias: Changes in hormones and increased blood volume can lead to irregular heart rhythms, which are generally benign but can be uncomfortable.
Managing Heart Health throughout Pregnancy:
Management of heart health during pregnancy involves several strategies to ensure the safety of both the mother and the fetus:
- Regular prenatal visits: Monitoring blood pressure and heart function regularly throughout pregnancy can help catch and manage any emerging issues early.
- Lifestyle modifications: Maintaining a healthy diet, regular exercise, and avoiding substances like tobacco and alcohol can significantly reduce cardiovascular risks.
- Medication management: For those with pre-existing heart conditions, managing medication carefully under the guidance of a healthcare provider is crucial. Some medications may need to be adjusted because they are unsafe for use during pregnancy.
- Targeted monitoring and interventions: For high-risk pregnancies, more intensive monitoring like echocardiograms or specialised maternal-fetal medicine consultations may be necessary.
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