Effect of Pregnancy on the Course of Heart Disease

Abstract

One hundred and six patients have been restudied three and one-half to 5 years (average 4.1 years) after they were observed with pregnancy and heart disease at the Boston Lying-in Hospital.This re-evaluation indicated that the altered circulatory dynamics of pregnancy may temporarily decrease functional capacity. However, no permanent change in degree of heart disease could be directly attributed to the pregnancy for which these patients were followed in 1950 and 1951. T HE woman with heart disease who has entered or is planning pregnancy will ask a series of questions involving her immediate and remote prognosis. One of the questions involves her chance of surviving pregnancy. Many studies have been reported evaluating the mortality during pregnancy and the puerperium in women with heart disease. This mortality varies from less than 1 per cent to more than 3 per cent in patients under careful medical management throughout their pregnancies. As pointed out by Hamilton' in his recent summary of cardiovascular problems in pregnancy, the immediate maternal mortality will be influenced by the severity of the heart disease at the time of pregnancy judged by a careful review of the patient's history, with particular regard to

Atrial Fibrillation and Pregnancy

“…Nevertheless, consideraton of data reported in the literature (Olesen, 1955;Wood, 1956;Rowe et al, 1960) and our own observations relating to the natural history of rheumatic heart disease have led us to believe that pregnancy, if appropriately managed and survived, does not accelerate the course of rheumatic heart disease, save perhaps in exceptional cases. This is also the view of several other workers (Miller andMetcalfe, 1956 Burwell, 1958 ;Gorenberg and Clhesley, 1958).…”