Pregnancy and Congenital Heart Disease

This book describes the risks facing patients with congenital heart disease who wish to become pregnant and the ways in which these patients can best be followed and treated during pregnancy. In addition, the organization of care around the delivery is discussed in detail. The first section provides clear advice on pre-pregnancy risk estimation, counseling of patients, medication use, and inheritance. The specific risks associated with congenital heart defects of differing severity are then explained, with guidance on monitoring and management. The coverage includes simple lesions such as atrial and ventricular septal defects, conditions associated with moderate risk, including tetralogy of Fallot and coarctation, and complex disease such as a Fontan or Mustard repair. The final section is devoted to delivery and considers the mode of delivery, anesthetic use, and postpartum care. Readers will find much information that is underreported in the literature, and the book goes well beyond the European Society of Cardiology guidelines, for example, by considering medical conditions not defined as high risk and addressing the organization of care thoroughly.

Prof. Jolien Roos-Hesselink has worked as a cardiologist since 1992 at the Erasmus MC, Department Congenital Cardiology. In 1987 she obtained her medical degree at the University of Utrecht. In 2004 she defended at the Erasmus University her thesis “Congenital Heart Disease at Adult Age”. Her clinical work and research interests lie in the area of adults with congenital heart defects, with special attention to the aortic valve defects and aortic pathology and pregnancy in people with heart disease. She was appointed in 2009 as Professor and Head of the Department of Congenital Cardiology at Erasmus MC. She is a board member of the European Working Group for congenital heart defects of the European Society of Cardiology (ESC) and founder and chairman of a major global registry on pregnancy in people with heart disease (ROPAC).

Prof. Mark Johnson is Professor in Clinical Obstetrics at Imperial College, based at Chelsea and Westminster Hospital. He qualified from St George’s Hospital Medical School in 1982 after accrediting in General Medicine, Endocrinology and Diabetes, he retrained in Obstetrics and Gynaecology. His early research work focused on the neuroendocrinology of the oxytocin and vasopressin release, but later moved into the endocrinology of obstetrics focusing on the role of the hormone relax in reproduction. Since then the most important topics in his research activity have become preterm labour and the impact of heart disease on pregnancy outcome. He works in the combined Cardiac Disease in Pregnancy Clinic of the Chelsea and Westminster and Royal Brompton Hospitals.