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Intrapartum Management of Maternal Congenital Heart Disease

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Abstract

Purpose of Review

This review discusses the special considerations in the care of pregnant patients with congenital heart disease (CHD) to minimize obstetric risks and avoid cardiac complications.

Recent Findings

Multidisciplinary team planning is a cornerstone in the care of patients with CHD in pregnancy. Most patients with CHD should have neuraxial anesthesia and laboratory monitoring during labor and delivery, but the need for pulse oximetry, telemetry, and invasive hemodynamic monitoring should be individualized based on patient risk. Additionally, most patients with CHD can safely have a vaginal delivery at 39–40 weeks without additional maternal morbidity. Cesarean delivery should be reserved for typical obstetric indications with some exceptions.

Summary

With thoughtful multidisciplinary team management, pregnancy and labor can be well tolerated in those with congenital heart disease. There are some congenital cardiac lesions that require invasive cardiac monitoring and/or consideration of delivery in a cardiac care unit.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, Brigham and Women’s Hospital, 75 Francis St, Boston, MA, 02115, USA

    Alexandria Williams & Katherine Economy

  2. Department of Cardiology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA

    Amrit Misra

  3. Department of Cardiology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA, 02115, USA

    Amrit Misra

Authors
  1. Alexandria Williams
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  2. Amrit Misra
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  3. Katherine Economy
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The first two authors listed contributed equally to the manuscript

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Correspondence to Alexandria Williams or Amrit Misra.

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All reported studies/experiments involving human or animal subjects performed by the authors were in accordance with the ethical standards of institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Williams, A., Misra, A. & Economy, K. Intrapartum Management of Maternal Congenital Heart Disease. Curr Obstet Gynecol Rep 12, 215–224 (2023). https://doi.org/10.1007/s13669-023-00369-4

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