Topic Overview

Women who have a heart valve disease and want to become pregnant have some special considerations. A valve disease may increase the risk to the mother and the developing baby (fetus). Treatment of a valve disease might have to change during a pregnancy.

How much a heart valve disease increases risks during pregnancy depends on the type of valve disease and how bad it is.

If you have a heart valve disease and are considering pregnancy, talk with your doctors. You can get more information about your individual risk factors and treatment needs before and after pregnancy.

Heart valve diseases

Heart valve problems that may increase the risk of problems during pregnancy include:¹

• Aortic valve regurgitation.
• Aortic valve stenosis.
• Mitral valve regurgitation.
• Mitral valve stenosis.

Risks during pregnancy

If you have a mild or moderate form of valve disease, and if your heart is pumping blood normally, you can likely have a normal pregnancy with careful medical supervision. Simple practices such as getting plenty of bed rest and avoiding lying on your back can play important roles in successfully managing your pregnancy. You might also take medicines during pregnancy.

If you have more severe valve disease with symptoms, you have a higher risk of problems during pregnancy. Your doctors may suggest that you consider surgery before you get pregnant. This might include a valve replacement surgery or a balloon valvotomy, depending on what type of valve problem you have.

Heart valve replacement surgery

If you already have a replaced valve and take warfarin, talk with your doctor before you get pregnant about your medicine options. You cannot take warfarin while you are pregnant. If you get pregnant, you will work with your doctor to choose an anticoagulant (such as heparin) that is safe for you to use during pregnancy.

If you are thinking about having a heart valve replaced before you get pregnant, you will have a choice of the type of heart valve you will get. The heart valve type you choose may depend on whether you plan to get pregnant in the future.

• Your valve can be replaced with either a mechanical or tissue valve.
• If you get a mechanical valve, you will need to take an anticoagulant, such as warfarin, for the rest of your life. But you cannot take warfarin during a pregnancy. You will work with your doctor to choose an anticoagulant (such as heparin) that is safe for you to use during pregnancy.
• If you get a tissue valve, you don't have to take anticoagulants long-term. But tissue valves don't last as long as mechanical valves. So you will need another surgery sooner than if you get a mechanical valve.

Treatment for heart valve disease during pregnancy

Treatments for a valve problem during pregnancy depend on the type of valve problem and how bad it is.

Medicine choices might include medicines that flush excess fluid out of the body (diuretics) and medicines to relax and expand the blood vessels.

A procedure that widens a heart valve might be done during pregnancy if the woman develops symptoms. This procedure, called a balloon valvuloplasty or valvotomy, is done for diseases that cause a heart valve to narrow (aortic valve stenosis and mitral valve stenosis). After the woman delivers, she may then have valve replacement surgery.¹