Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal health
With the growth of the adult congenital heart disease (CHD) population, so do the considerations of reproduction, contraception and maternal health become more pressing. Fertility issues and concerns about hereditability may impact both male and female CHD patients. CHD can also influence the choice...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-07-01
|
| Series: | International Journal of Cardiology Congenital Heart Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666668520300495 |
| _version_ | 1818441416158740480 |
|---|---|
| author | Karishma P. Ramlakhan Imran Ahmed Mark R. Johnson Jolien W. Roos-Hesselink |
| author_facet | Karishma P. Ramlakhan Imran Ahmed Mark R. Johnson Jolien W. Roos-Hesselink |
| author_sort | Karishma P. Ramlakhan |
| collection | DOAJ |
| description | With the growth of the adult congenital heart disease (CHD) population, so do the considerations of reproduction, contraception and maternal health become more pressing. Fertility issues and concerns about hereditability may impact both male and female CHD patients. CHD can also influence the choice between contraceptive options, as some involve cardiovascular risks that make them less well-suited to the cardiac patient. For women with CHD, pregnancy acts as a haemodynamic stress test for the maternal cardiovascular system and often precipitates cardiac complications including heart failure, arrhythmias and thromboembolic events. For those with CHD, preconception counselling on the cardiac, obstetric and fetal risks involved in pregnancy is crucial for shared decision making and to optimize pregnancy outcomes. Risk stratification should be individualized, multidisciplinary and includes consideration of the complexity of the original CHD lesion, any residual or recurrent lesions, functional class, ventricular and valvular function, cyanosis, previous cardiac events and comorbidities, as well as the use of diagnostic modalities.In this review, we examine reproductive concerns in CHD patients, including preconception counselling, fertility issues and hereditability of CHD. We describe the advantages and disadvantages of the currently available contraceptive options in the context of cardiac disease. We discuss general considerations in the management of pregnancy in CHD, as well as the current knowledge on the most common CHD lesions. |
| first_indexed | 2024-12-14T18:27:54Z |
| format | Article |
| id | doaj.art-1f895d80816e477e85550652a1d01907 |
| institution | Directory Open Access Journal |
| issn | 2666-6685 |
| language | English |
| last_indexed | 2024-12-14T18:27:54Z |
| publishDate | 2020-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj.art-1f895d80816e477e85550652a1d019072022-12-21T22:51:53ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852020-07-011100049Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal healthKarishma P. Ramlakhan0Imran Ahmed1Mark R. Johnson2Jolien W. Roos-Hesselink3Department of Cardiology, Erasmus University Medical Center, Rotterdam, the NetherlandsAcademic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, United KingdomAcademic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, London, United KingdomDepartment of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Corresponding author. Erasmus University Medical Center, Department of Cardiology, Rg-435, P.O. Box: 2040, 3000, CA Rotterdam, the Netherlands.With the growth of the adult congenital heart disease (CHD) population, so do the considerations of reproduction, contraception and maternal health become more pressing. Fertility issues and concerns about hereditability may impact both male and female CHD patients. CHD can also influence the choice between contraceptive options, as some involve cardiovascular risks that make them less well-suited to the cardiac patient. For women with CHD, pregnancy acts as a haemodynamic stress test for the maternal cardiovascular system and often precipitates cardiac complications including heart failure, arrhythmias and thromboembolic events. For those with CHD, preconception counselling on the cardiac, obstetric and fetal risks involved in pregnancy is crucial for shared decision making and to optimize pregnancy outcomes. Risk stratification should be individualized, multidisciplinary and includes consideration of the complexity of the original CHD lesion, any residual or recurrent lesions, functional class, ventricular and valvular function, cyanosis, previous cardiac events and comorbidities, as well as the use of diagnostic modalities.In this review, we examine reproductive concerns in CHD patients, including preconception counselling, fertility issues and hereditability of CHD. We describe the advantages and disadvantages of the currently available contraceptive options in the context of cardiac disease. We discuss general considerations in the management of pregnancy in CHD, as well as the current knowledge on the most common CHD lesions.http://www.sciencedirect.com/science/article/pii/S2666668520300495Congenital heart diseasePregnancyReproductive healthContraceptionMaternal healthCardiovascular disease |
| spellingShingle | Karishma P. Ramlakhan Imran Ahmed Mark R. Johnson Jolien W. Roos-Hesselink Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal health International Journal of Cardiology Congenital Heart Disease Congenital heart disease Pregnancy Reproductive health Contraception Maternal health Cardiovascular disease |
| title | Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal health |
| title_full | Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal health |
| title_fullStr | Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal health |
| title_full_unstemmed | Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal health |
| title_short | Congenital heart disease and family planning: Preconception care, reproduction, contraception and maternal health |
| title_sort | congenital heart disease and family planning preconception care reproduction contraception and maternal health |
| topic | Congenital heart disease Pregnancy Reproductive health Contraception Maternal health Cardiovascular disease |
| url | http://www.sciencedirect.com/science/article/pii/S2666668520300495 |
| work_keys_str_mv | AT karishmapramlakhan congenitalheartdiseaseandfamilyplanningpreconceptioncarereproductioncontraceptionandmaternalhealth AT imranahmed congenitalheartdiseaseandfamilyplanningpreconceptioncarereproductioncontraceptionandmaternalhealth AT markrjohnson congenitalheartdiseaseandfamilyplanningpreconceptioncarereproductioncontraceptionandmaternalhealth AT jolienwrooshesselink congenitalheartdiseaseandfamilyplanningpreconceptioncarereproductioncontraceptionandmaternalhealth |