Many Pregnant Women With Heart Defects Do Not Get Proper Tests: Study

Women with congenital heart problems may experience more cardiovascular side effects during pregnancy than women without heart problems, but often don’t get the tests they need to assess the risk, according to the findings of a new study.

Researchers with the U.S. Centers for Disease Control and Prevention (CDC) warn that the tests, which assess the risks of heart problems before a pregnant woman gives birth, are under-utilized, which may mean some women experience heart complications which were avoidable. The findings were published earlier this week in the journal Circulation: Cardiovascular Quality and Outcomes.

Congenital heart defects (CHD) affect the structure of the heart and how blood flows to the rest of the body. The defects can be fatal, but many people are born with CHD and continue to lead healthy lives. However, they should receive increased medical monitoring, especially during pregnancy, which puts a woman’s body under more stress.

Pregnant women with congenital heart disease experience adverse conditions 34 to 63 times more frequently than women without heart defects, the researchers noted. These conditions include high blood pressure in the lungs, heart rate problems, dangerous heat rhythms, and cardiac arrest.

Women with CHD are more likely to experience stillbirth and preterm delivery because of the complications related to their condition.

CDC researchers used U.S. healthcare claims data from 2007 to 2014 to find women with and without congenital heart defects ages 15 to 44 years with private insurance covering prescriptions during pregnancy. This included more than 2,000 women with congenital heart defects and 1.3 million women without.

According to the findings of the study, however, despite pregnant women with CHD being more likely to experience adverse conditions, only 56% will receive comprehensive echocardiograms of the heart. This is a painless test that uses ultrasound to visualize the beating of the heart and the pumping of the blood to detect abnormalities.

About 4% of pregnant women with CHD filled prescriptions for teratogenic or fetotoxic cardiac-related prescriptions, according to the findings. These prescriptions can help control heart side effects during pregnancy but may place the baby at increased risk.

The American Heart Association recommends doctors of pregnant women with congenital heart defects assess cardiac health early in pregnancy with an echocardiogram and discuss risks and benefits of cardiac-related medications.

Women and their doctors should be aware of the increased risk to women with CHD and focus on increased communication during pregnancy, the researchers wrote.

Roughly 40,000 infants are born each year in the United States with congenital heart defects. More than 1.4 million American adults currently live with CHD in the U.S.

The study did not indicate why half of the women who should have received echocardiograms did not receive them from their health care providers. However, the researchers emphasized the need for doctors and patients to be aware of the guidelines to ensure women with CHD are receiving the specialized treatment they need, especially if they become pregnant.