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Cardiovascular Symptoms

Gestational Diabetes

Nearly 10% of all pregnancies are affected by gestational diabetes. It is high blood sugar levels during pregnancy, if not managed can cause serious complications. There isn’t a single cause to gestational diabetes, the body goes through numerous changes during pregnancy including insulin resistance. Gestational diabetes increases the risk of cardiovascular disease and hypertension.

Risk factors include: 

  • Overweight before pregnancy
  • Prediabetes
  • Past gestational diabetes
  • High blood pressure, high cholesterol, heart disease

Treatment  

  • Initial treatment involves behavioral management such as:
  • Healthy Eating
  • Regular physical activity
  • Monitor blood sugar levels
  • Talking to your doctor

Suggested blood sugar levels during pregnancy 

  • Before a meal: 95 mg/dl or less
  • One hour after a meal: 140 mg/dl or less
  • Two hours after a meal: 120 mg/dl or less

Recommended screenings for gestational diabetes pregnancies  

  • Clinical guidelines recommend a screening 4 to 12 weeks after a gestational diabetes mellitus (GDM) pregnancy. Low-income and racial/ethnic minority populations are less likely to receive the screening postpartum. After the initial postpartum screening, regular rescreening should be conducted. Being aware of screening recommendations can prevent or delay progression of type 2 diabetes
  • For more information relating to gestational diabetes visit, Gestational Diabetes and Pregnancy.

Pregnancy With a Heart Condition

A successful pregnancy and delivery is possible with a heart condition or disease.

  • If you are aware of your condition before you plan on getting pregnant, talk with your cardiologist and healthcare provider about the risks.
  • There are higher risks for women with pre-existing conditions of high blood pressure, heart disease when pregnant. Taking care of yourself is very important for you and your baby:
  • Go to all prenatal visits to monitor the health of you and your baby.
  • Avoid excessive stress and anxiety which can elevate your blood pressure and put excess strain to your heart.
  • Monitor weight gain during pregnancy as excessive weight gain can put additional stress on the heart.
  • Constant communication with your healthcare team is important for a safe pregnancy and delivery.
  • The Northwestern Medicine Heart Disease and Pregnancy Program has a number of specialists to help with all forms of heart disease during pregnancy. The program also provides information on heart disease and pregnancy from preconception evaluation to labor and delivery. Visit Heart Disease and Pregnancy to learn more.

Cardiovascular Conditions During Pregnancy

Due to increased stress the heart endures during pregnancy, cardiovascular disorders can develop.

Hypertension 

  • High blood pressure (hypertension) can put the mother and baby at risk during pregnancy, delivery and after the baby is born. There are many risk factors that can increase your risk of developing hypertension during pregnancy that includes history of hypertension, first pregnancy, women older than 35, Black women, obesity and multiple pregnancies. Hypertensions can cause a number of cardiovascular complications for the mother that can include:
    • Preeclampsia is characterized by high blood pressure and can damage other organ systems, like the kidneys and liver. Symptoms usually begin after 20 weeks of pregnancy in women with normal blood pressure. Symptoms include:
      • Severe headaches
      • Change in vision (temporary loss, blurred, light sensitivity)
      • Nausea or vomiting
      • Decreased urine output
      • Shortness of breath
    • Eclampsia is a life-threatening complication to develop seizures and coma. Preeclampsia can often progress severe preeclampsia and ultimately eclampsia.
    • Stroke occurs when there is an interrupted or reduced blood supply to the brain. Preeclampsia and eclampsia are both risk factors for developing a stroke during delivery or after.

 

Heart Failure 

  • Peripartum Cardiomyopathy, also known as postpartum cardiomyopathy, is a form of heart failure that happens during the last month of pregnancy or 5 months after delivery. Within this condition the heart chambers grow bigger and the heart muscles weaken which leads to less blood flow. The heart is not able to deliver the body’s demands for oxygen in the blood and starts to affect other organs. Symptoms include:
  • Fatigue
  • Palpitations
  • Increased urination at night
  • Swollen ankles
  • Swollen neck veins
  • Low blood pressure, or sudden drop when standing up
  • For more information on peripartum cardiomyopathy visit the American Heart Association website, Peripartum Cardiomyopathy.

Arrhythmia

  • A condition in which the heart beats irregularly or at an abnormal rhythm. It is the most common cardiac disorder during pregnancy and can be an indicator of an unknown heart condition.

Cardiovascular Health

Cardiovascular disease makes up 15.5% of all pregnancy related deaths. Blood volume increases from 30-50% during pregnancy which means the heart is doing more work. The heart works 2x more during pregnancy to circulate nourishment for the fetus. It is important to keep optimal cardiovascular health and be able to recognize alarming cardiovascular symptoms that can happen during pregnancy and birth.

Cardiovascular symptoms during pregnancy 

  • Due to the excess exhaustion that your heart is under it can cause several symptoms. Most of them are normal, however others can indicate an underlying condition. Talk with your doctor about anything that you are concerned about. Symptoms include:
    • Lightheadedness/fainting
    • Dyspnea
    • Severe or mild orthopnea
    • Palpitations that persist or worsen with exertion
    • Chest pain
    • Severe shortness of breath at rest

Risk factors  

  • There are several risk factors to be aware of that can cause heart disease or complications during pregnancy.
    • Over the age of 30 during pregnancy
    • Multiple pregnancies
    • History of preeclampsia or gestational diabetes in other pregnancies
    • Pre-existing heart disease: cardiomyopathy, myocarditis, endocarditis, arrhythmias and congenital heart disease
    • Substance abuse during pregnancy
    • Obesity, diabetes, or high blood pressure
    • Poor nutrition before or during pregnancy
    • Black women are statistically more at risk for cardiovascular disorders during pregnancy

Improve cardiovascular symptoms during pregnancy 

  • The heart goes through immense exertion during pregnancy. There are several factors that you can do to improve or maintain cardiovascular health during and after pregnancy:
    • Regular physical activity
    • Avoid alcohol, smoking, and any form of drug
    • Manage stress
    • Eat healthy