Cardiac Maternity

Care Provided By Dr. Carla Canniffe

Pregnancy Care for Women with Heart Disease

The risk of pregnancy in women with a heart condition varies greatly depending on the underlying condition and their current health. There can be a risk both to the mother and the fetus.

All women with a known cardiac or aortic condition should see an expert in advance of planning a pregnancy to discuss possible risks and any necessary precautions that should be taken. For a small number of patients, pregnancy is not advised, so reliable birth control (contraceptive) options should be discussed.

Dr. Canniffe has trained in Cardiac Maternity Medicine in St. Barts Cardiac Centre, The Royal London & University College London Hospital and is experienced in managing high risk cardiac pregnancies.

The aim of our clinic is to enable women with pre-existing cardiac conditions, or a cardiac condition which arises during pregnancy, to achieve a successful pregnancy and birth.
We provide a dedicated service to support women considering pregnancy, as well as providing careful monitoring during pregnancy.

Cardiac Maternity Services

The possible risks of pregnancy vary greatly depending on the underlying cardiac condition. All women with a known cardiac condition should discuss these possible risks with an expert in the field, prior to undertaking pregnancy.

Part of this process is having up to date cardiac information – documented baseline symptoms, exercise capacity (treadmill test), imaging (echo or cardiac MRI) and rhythm (ECG or Holter).

We provide this service at our clinic, firstly by updating any necessary cardiac investigations and then by having an individualised discussion with the patient regarding what they might expect during pregnancy and what risks might apply to them. This includes addressing which medications are safe to use in pregnancy and breastfeeding.

We also aim to set out a clear schedule for how often cardiac monitoring during pregnancy would need to take place and whether any specialised scan of the fetus should be performed during the pregnancy.

The frequency of cardiac monitoring during pregnancy depends on the underlying condition. Monitoring usually involves a cardiac appointment where we assess symptoms and perform a cardiac examination, blood pressure check and cardiac imaging (echo)- but monitoring is always tailored on an individual basis.

We try to set out a schedule prior to pregnancy as to how often cardiac monitoring might be needed, however this can change if a patient develops symptoms or complications during the pregnancy.

If specialist imaging of your baby’s heart (fetal echocardiography) is required, we will coordinate this with the most appropriate local unit.

We work closely with the obstetric team & GP involved in each patient’s care (as well as other medical specialists, as required) to ensure that all the teams involved are aware of any specific cardiac risks and if any management.

We work closely with the obstetric team, GP and all other specialists involved in each patient’s care during pregnancy to develop a delivery plan.

This plan outlines the underlying cardiac condition, the appropriate site (hospital) for delivery, the appropriate mode of delivery (c-section or vaginal etc.) and whether any specific precautions need to be taken.

In our experience, delivery plans have helped both medical staff and patients have a positive experience during pregnancy and delivery. They minimise unforeseen complications and allow for safe and effective planning.

The haemodynamic and hormonal changes of pregnancy can have an impact on heart health for months after pregnancy. As such we arrange the appropriate follow up for each patient. This involves 1 – 2 clinic visits with a medical examination, rhythm check and imaging of the heart (echo). We also provide clear advice on any changes to medications and safety of such medications if the patient is choosing to breastfeed. Contraceptive options for the future would also be discussed at follow up appointments.

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