Pregnancy should be a time of great joy for every woman experiencing it. Yes, there are some definite negatives that accompany it, most notably mentioned being the weight gain, body changes and acquired aches or pains. But the end result should be a healthy little boy or girl that most mothers would say are worth any of the trouble they endured. That being said, it is hard to imagine that pregnancy could be a provoker of underlying health issues that could have fatal consequences.
According to the American College of Obstetricians and Gynecologists (ACOG), heart disease accounts for almost 27% of pregnancy-related deaths. Many of these types of deaths are viewed as preventable, which has prompted them to put forth new guidelines on screening, diagnosis and management of heart disease. The most common risk factors for maternal death include:
- Race (African-Americans have a 3.4 times greater risk than white women)
- Age
- Obesity
Additionally, a heart muscle disease called peripartum cardiomyopathy is the leading cause of death in expectant mothers, accounting for 23% of deaths late in pregnancy. It is classified as a weakness of the heart muscle that can begin during the final month of pregnancy through about five months after delivery, without any other known cause. Most commonly, it occurs right after delivery. It is a rare condition that can carry mild or severe symptoms.
Because of all the structural, biochemical and physiological changes that occur during pregnancy, it may be one of the most stressful events that a woman will experience in her lifetime. When the body is overwhelmed with stress of any type, it has a much harder time being able to do all the normal jobs we expect it to do, in addition to managing the newly imposed stresses. If it continues long enough, health breaks down and issues arise.
In a measure to help identify moms who may be at risk for cardiovascular problems, the ACOG has recommended implementation of the California CVD Tool Kit algorithm. A woman’s body sees a considerable increase in blood volume during pregnancy, so those dealing with cardiovascular issues that are already taxing the heart would need to be monitored very carefully. The algorithm was also implemented due to research that found about 9 in 10 pregnant women and new moms who died of heart disease would have been identified as high risk and possibly could have been managed more safely.
If you are thinking about becoming pregnant, then start planning early! Not just for rooms and clothes and baby names, but to ensure that you protect yourself against cardiovascular risk. That may mean consulting with a few different heath care professionals to make sure you have all bases covered, are not already at risk, and if you are, implementing a plan to get your body healthier and ready for the host of changes it will need to adapt to during pregnancy.
Post-partum planning is also important as the increased risk of death from heart disease can last up to a year after a woman gives birth. It never hurts to be overly cautious and take as many steps as possible to set yourself up for the best outcome with your pregnancy. Prevention is the key! And if you plan properly, a joyous event will await you nine months later!
The practice guidelines were published in the May issue of the journal Obstetrics & Gynecology
