Professional Documents
Culture Documents
Unplanned pregnancy can be disastrous for patients with congenital heart defects. It
is vital that they are given adequate and accurate advice about which forms of
contraception are suitable for them. The contraceptive efficacy of each different
method must be given consideration.
EMERGENCY MORNING AFTER CONTRACEPTION
No cardiac contra-indication to the morning after pill. Those on warfarin should have
their INR checked after 48 hrs.
BARRIER METHODS
Contraceptive failure rate 15 -30% / year
Can be used for any cardiac condition
COMBINED ORAL CONTRACEPTIVE PILL
Contraceptive failure rate 3 - 8% / year
Avoid in
SEVERE RISK
Maternal mortality expected in up to 50%
Pulmonary hypertension
Severe left heart obstruction
>moderate systemic ventricular impairment (Ej # < 30%)
Marfans syndrome with dilated aortic root >40mm
Women with congenital heart defects in class 1 or class 2 should attend the ACHD
specialist centre or the local ACHD centre for pre-pregnancy assessment and
counselling. This will sometimes involve extensive investigations including cardiac
catheterisation, exercise testing, and imaging. Occasionally it is advisable that a
woman undergoes surgery or intervention prior to embarking on a pregnancy. In
women with moderate risk pregnancies, care should take place in a combined high
risk cardiac obstetric clinic