Today, March 14, the European Day for the Prevention of Cardiovascular Risk is celebrated, to remember the importance of prevention in the field of these pathologies. Cardiovascular risk is understood as the plikelihood of a person suffering from cardiovascular disease within a specified period of time, in this case we will focus on pregnancy.
In pregnancy and childbirth, a woman's body undergoes a series of physiological changes in your cardiovascular system. These changes are not a problem for most women, but if you suffer from cardiovascular disease or heart disease, it can be treated as a high-risk pregnancy.
Cardiovascular changes during pregnancy
During pregnancy they occur in the women's body major metabolic changes. This meets your needs and those of the growing fetus. This adaptation of the woman's body occurs from the beginning of pregnancy, there are hormonal changes, a presence of uteroplacental circulation and an increase in the size of the uterus.
We list some of the major changes in the circulatory system During pregnancy:
- Increase in blood volume by 30-50% from the sixth week. The maximum volume is reached in weeks 20-24, and is maintained until delivery.
- Get your heart rate up. A woman's heart pumps faster, so the heart rate goes from 10 to 15 beats per minute.
- Increase in cardiac output, rises by 30-40%.
- Lowering of peripheral resistances.
- Lowers blood pressure by dilation of blood vessels. The heart is also dilated, it can increase its size up to 30%.
These changes that occur during pregnancy, in women who have heart disease, can increase the risk of complications, both in them and in the fetus. What's more, many of the congenital heart defects are inherited. This risk is estimated at around 4%, compared to the risk of congenital heart disease in the general population of 0,8%.
Cardiovascular risk, questions to know
Have a higher chance of Having cardiovascular disease is associated with two types of factors. These risks can be on the one hand internal, for example, genetic, age, and on the other hand, external. Among the latter and that we can control are environmental pollution, tobacco, obesity, cholesterol, not practicing sports ...
The repeat miscarriages are often related to thrombophilia, up to 50%. Therefore, it is important to study women with a personal or family history of repeated abortions, in order to take adequate preventive measures. On the other hand, both sustained arrhythmias and extrasystoles are more frequent during pregnancy, but they should be treated as conservatively as possible.
Some women with severe heart disease, pregnancy is contraindicated, due to the risk to their health or that of the future baby. The good news is that advances in pediatric cardiology and cardiac surgery have allowed more than 85% of children with congenital heart disease to survive to adulthood.
What are the risks during pregnancy?
All the Heart disease, congenital or acquired, is the leading cause of maternal death of non-obstetric origin. Therefore, it is essential to go to the doctor if you want to be a mother, or if you are already pregnant. In general, antenatal care and delivery are required to be carefully planned.
In general, and as it is necessary to increase blood volume and cardiac output, it is possible that in pregnant women there is decompensation or heart failure. This has repercussions in a number of fetal complications and neonatal, such as:
- Intrauterine growth retardation
- Fetal suffering
- Intracranial hemorrhage
- Premature birth
- Perinatal mortality of 18%
In the case of grade I heart disease, or mild, a more exhaustive control will be needed, both of the mother and the fetus, to carry the pregnancy to a successful conclusion. The moments of special risk occur at the end of the first trimester, between weeks 28 and 32, during childbirth and the early puerperium, the first 10 days after it.