Pregnancy complicated with heart disease is a serious obstetric complication and the third leading cause of maternal mortality in China, accounting for the first non direct obstetric cause of death. Due to pregnancy, the uterus enlarges and blood volume increases, which increases the burden on the heart. During delivery, the contraction of the uterus and skeletal muscles throughout the body causes a large amount of blood to flow towards the heart. The increase in postpartum circulating blood volume can easily lead to heart failure in diseased hearts. Meanwhile, due to long-term chronic hypoxia, fetal intrauterine growth retardation and fetal distress may occur.
The impact of pregnancy complicated with heart disease on the fetus is related to the severity of the condition and the compensatory state of cardiac function. Those with mild symptoms and good compensatory function have little impact on the fetus; If heart failure occurs, it can cause miscarriage, premature birth, or stillbirth due to uterine congestion and hypoxia. The influence of pregnancy and childbirth on pregnancy complicated with heart disease Within 1 to 2 days after delivery, the water trapped in the tissue enters the blood circulation, causing a temporary increase in the blood volume of the systemic circulation and an increase in the heart load. The three most dangerous periods for pregnancy complicated with heart disease are as follows:
1. Pregnancy: During pregnancy, the total blood volume increases by about 30-40%, especially reaching its peak at 32-34 weeks, when the burden on the heart is also the heaviest.
2. Delivery period: The increase in cardiac burden during delivery is more significant. About 300-500ml of blood enters the central circulation from the uterine wall during each contraction. In addition to uterine contractions, the abdominal and skeletal muscles also contract during the second stage of labor. In addition, the forceful exhalation during labor increases the pulmonary/abdominal pressure, and the burden on the heart is heaviest at this time. The placental circulation stops during the third stage of labor. Easy to cause heart failure; On the other hand, due to a sudden decrease in intra-abdominal pressure, a large amount of blood is trapped in the visceral vascular bed, resulting in a severe reduction in circulating blood and peripheral circulatory failure.
3. Puerperal period: within 1-3 days after delivery, the water trapped in the tissue enters the blood circulation, causing another temporary increase in the blood volume of the systemic circulation, aggravating the heart load, and returning to normal four to six weeks after delivery.
To prevent pregnancy complicated with heart disease, pregnant women should pay attention to regular prenatal check ups, which can reduce the incidence and mortality of heart failure; Maintain appropriate rest, get at least 10 hours of sleep per day, avoid overexertion, and avoid emotional excitement; Pay attention to dietary nutrition and consume a diet rich in vitamins, high protein, and low carbohydrates; Upper respiratory tract infections and anemia are common causes of gestational heart failure, so it is necessary to strengthen prevention of various infections. Even if you have a cold, you should rest in bed. If you have a fever or persistent cough, you should be hospitalized for treatment. If you have anemia, you can take iron supplements and folic acid.
