Pregnancy with Mitral Regurgitation

[bvdr]

Billy,

I had never heard that either. I am another one who had precipitious labor and delivery........under one hour each time. I had valve problems then but no one knew it. I guess that is one good thing about valve problems if there really is a connection.

 

[Christian]

Ok, lets see if I can figure this out:

Yup. Whew.

Anyway, here it is. I think it was waving "hello."

 

[Karlynn]

Ah, looks just like Daddy!


Keep the reports coming. Does your wife know we're all planning on coming and being in the delivery room? We thought you'd like the support.

 

[Christian]

If there's one thing Jill loves, it's a party. Unfortunately, she's going to give birth in an ICU bed -- I'm not even 100% sure that I'll be allowed inside.

No problems with this week's appointment. Everything was totally normal and we don't have anything scheduled for April. I'll be back in May after we do the cardiologist rounds.

 

[Debrinha GT]

Never give up

Never give up

Hello, At the age of seven I was a victim of rheumatic fever and since parents didn't have much access to information on those days, by the time my mother took me to the doctor's, the illness had already affected my heart and after having spent over two years confined to a bed, I was then operated on at ten by the most famous doctor in Brazil and one of the best in the world at the time. I was the first child to have a MVR in this country and although the doctor didn't believe I would make it due to the seriousness of my problem, here I am, still coming to terms with the fact that I'll need the fourth one sooner or later. Anyway, my cardiologist here in Curitiba said she was totally against me ever getting pregnant and since I was quite young at the time, I never questioned it. However, years later while I was living in Scotland, I began to feel the need of a child in my life and that was when my husband and I decided to talk to the doctor who was taking care of me there. After examining me, he said he didn't see why I couldn't since my valve was in very good shape. Well, after having heard the opposing opinion for such a long time, of course I felt insecure and abandoned the idea for a few years. When we returned to Brazil, I went years without thinking about it but I guess it had always been there at the back of my mind and it was only in 1994 when I started seeing another doctor, that I began to believe I really had a chance. Unfortunately, my plans had to be postponed yet again because in 1995 I got sick again and had to have my third surgery. I then opted for another tissue valve so that I could have a baby. Six months after the operation I was pregnant and there were no problems at all, lots of women would have loved to have a pregnancy like mine. Just before the 9th month was up, I gave birth to Bruna by C- section. She's a perfectly seven-year-old girl with no health problems at all. Tell yur wife to follow her heart and dream and everything will be just fine for both of you. Good luck and God bless!

 

[Lisa in Katy]

Congrats to you and your wife.

I had two wonderful pregnancies before having mitral valve replacement. I only gained 21 pounds with the first and 19 with the second (even with diabetes with the second which generally leads to large weight gains). I had a fairly "short" labor with each (9 hours with number 1 and 6 with number 2), but was given pitocin to strenghthen contractions with the first and induced on the second, so can't say that it would have been short otherwise. With my second, I apparently delivered in an ICU bed - at least that's what showed up on my bill - but actually was in a regular labor and delivery bed. I think the ICU designation might have actually referred to the extra monitor that monitored my heart rate, as well as more frequent visits by the nurses. My husband, sister-in-law, and mom were in the room most of the time, as well as other drop-in guests. I would think that a delivery in a true ICU would be very disturbing to the other patients and practically impossible since those beds aren't made to "come apart" to facilitate a delivery. Perhaps this is something you should talk to your doctor about.

 

[Christian]

Well, we're just about through the 4th month of the pregnancy. We spent yesterday at the Cleveland Clinic and got nothing but good news, though the echo report won't be mailed out until next week.

Here's what we learned:

1. Heart enlargement during pregnancy is normal and happens regardless of whether there's a heart defect or not. Our doctor told us to "ignore" any change in the dimensions of Jill's heart on the echo report unless he tells us otherwise. He expects any enlargement to reverse itself after the pregnancy.

2. Valve regurgitation during a pregnancy can increase due to increased blood volume and can decrease due to the reduction in systemic pressure (veins and arteries dilate during pregnancy). The net effect is usually a wash.

3. Preclampsia (hypertention caused by pregnancy) is our enemy. Preclampsia could offset the decrease in systemic pressure and make things tricky and upset the aforementioned balance. Fortunately, Jill's blood pressure was 105/65.

4. Atrial fibrillation is a possible risk, but we haven't had any problems yet.

5. Heart murmurs get louder during pregnancy.

Anyway, Jill checked out a-ok. No symptoms, no heart failure, no nothing. The doctor told us that we made the right choice, and if he was in our shoes, he'd have made the same decision. That gave me some comfort. Based on his experiences with women like Jill (60-70 people), he expressed the risks of a "bad" result (heart repair surgery and/or an emergency C-Section caused by heart issues) as being "less than 3%."

One interesting sidenote: I got my hands on Jill's file -- if any of you are Cleveland Clinic patients and have a stress echo, see if you can get your file. The CCF is now including mortality analyses with their echo reports to make the surgery-now-or-surgery-later decisions. People of Jill's age with Jill's heart defect and Jill's stress echo results have (based on historical statistics) a 1 in 250 chance of dying of heart disease during the next 5 year period if surgical correction is not undertaken. Surgery is typically considered when that number hits 1 in 100. Once it's higher than 1 in 20, surgery is pushed. Food for thought.

 

[Karlynn]

Christian,
Thanks for the continued updates. I'm so glad things are going well. I had A-fib during my second child's pregnancy (not my first) and was treated with a low dose beta blocker. It wasn't a big deal (my problems increased after the pregnancy).

I hope you and Jill are racking up the sleep hours and banking them to draw from in about 5 months!

 

[weekycat]

Congratulations!

Congratulations!

Welcome to our family Christian, and congrats to the two of you.

I was also born with a heart murmur, but never knew about it until 5 years after having my first 3 kids at about age 30, when my doctor mentioned it. And my mother said, oh yeah...some of you kids had heart murmurs when you were born... I did have 9 siblings, so I guess I can't be too hard on her for not remembering which ones.

Then about 8 years later, while pregnant with the 4th one, another doctor mentioned my murmur in passing... never even had it checked out. That pregnancy too, was uneventful, and I had no idea that I had any kind of a heart problem until 4 years later. I went in for a routine physical 5 months after my 5th pregnancy ended in miscarriage.

That's when I found out that I had MVP with moderate-severe regurgitation. At that point I was told that I MIGHT need surgery some day...maybe 5 or 10 years later...maybe never. Well...I ended up having surgery 6 mos. later.

I don't think you or your wife have anything to worry about, (although I've always wondered if my heart problem had anything to do with my mc), the doctors have never confirmed this. It likely had more to do with the fact that I was 43 years old, as my other pregnancies were all uneventful.

The only thing I would caution about, is that each progressive pregnancy could probably do a little more damage??

Good Luck with your pregnancy, and keep posting pictures of your beautiful little kid(ney bean).

 

[Christian]

Weekycat, we also wonder whether successive pregnancies could hasten the deterioration of a valve. But we'll save that for later.

Anyway, we're just about at the halfway point. The recent CCF report (from early May) reported the same old moderate-to-severe regurgitation. But it's caused no problems so far.

Baby is a boy, by the way. It doesn't look like a bean anymore.

 

[KimC]

Christian,

Congratulations to you and Jill. I have three children, Jessica (6), Samantha (3) and Coulson, (10 months old today).

You're way ahead of the game to have the "hard core" docs on your team. Listen to their advice but also listen to your wife. If she starts to feel exhausted or have difficulty breathing, don't be afraid to ask for another echo or opinion. (Ideally, you'll move to Cleveland for the remainder of the pregnancy).

Another thing to consider during labor is oxygen and blood pressure monitoring. Don't leave it to the nurses. Have your "birth plan" ready.

Cheers,

 

[Marty]

Pregnancy and MVP

Pregnancy and MVP

I got to this thread late but found it most interesting and informative. Here is some ancient history and maybe some hope for Christian. Alice and I were married in September 1950. She was a nurse at the hospital where I was interning. Any how, she had a heart murmur and the chief cardiology resident said if we planned on having a family "get started soon" Alice was 23 and I was 24. We quickly had three kids now age 53, and 51 girls and a boy 49. Alice is now 76 and has had her problems with borderline CHF, Afib, etc. She is on high powered medicines like Betapace, Hyzaar, etc.Today she is fine and can do everything including vacuuming a house with a lot of carpets. Her doctors have discussed surgery for her mitral regurg at times but have never recommended it. So mitral regurg is an iffy condition and not all cases go to surgery.Only my son has MVP and four grandchildren are OK so far.

 

[Christian]

Thanks for the story, Marty. And Kim, I went back and read your early posts. Interesting stuff. My wife hasn't had any of the symptoms that you had. I'm guessing that's either because it's too early (20 weeks) or because her heart is accustomed to some regurgitation.

We had a fetal echocardiogram today and we think the baby's heart checked out fine (we won't get final word until later). Another relief.

I'm certainly not complaining, but our biggest snag so far is choosing a darn name! We had the perfect girl's name picked out, but can't agree on anything now that we know it's a boy. It might have to come down to a coin flip.

 

[KimC]

Christian,

My cardio's not convinced that valve disease was the cause of my symptoms during the pregnancy but something was wrong, either undiagnosed pulmonary disease or pressure on my heart from the third pregnancy and two moderate and one mild valve leak. (I was diagnosed with asthma in January, and am being treated for SOB.

Last September I was told that surgery may be indicated, if my heart continued to enlarge postpartum. Recent echoes have shown a return to almost normal chamber sizes. (The right atrium and estimated pressure on it is still elevated).

I'm undergoing catherization next month for further exploration. My cardio mentioned possible pulmonary hypertension but who knows. The only remaining mystery to solve is the cause of my recurring chest pain. I've been told from a doc at the CCF that it's probably coronary vasospasms or variant angina from the aortic leak. My local cardio thinks it could be microvascular angina, but the CCF is skeptical about that diagnosis, hence the cath.

Re: boy names, we chose "Coulson," my mother's maiden name. Choosing a name for our second child, (a girl) was difficult. I wanted to use "Isabella," but my in-laws couldn't understand why we'd use a "Hispanic" name. Ugh.

Buena suerte,

 

[Christian]

Had I been a girl, I'd have been an "Isabella."

 

[KimC]

I was a "wuss," (to steal a word from another VR.com member) not to use Isabella. It's classic.

Best,

 

[kurli]

Congratulations on the baby. I hope everything keeps going well for you all.
I had my 18 month post op check up the other week and I got the all clear to have a child........... it was such a releif as I'd not been sure if I would be strong enough to carry a child. But thank God I am.
It's encouraging to hear of other women with heart probs having trouble free pregnancies.
And I have chosen isabella as a girls name for when it actually happens. It's obviously very popular........ i have loved it forever.
Any way keep us posted.
Amy

 

[hensylee]

Christian, there's nothing wrong with a second Christian. It's a beautiful name. So good of your parents to give it to you.

Joy has not jumped in here. She's one of our babies (in her 20s) of VR. She, too, had pregnancies with heart problems, but seems to be getting on quite well.

This thread is needed because others have asked about pregnancy pros and cons. Your thread will be recommended hereafter.

Beautiful baby you have there.

 

[Christian]

111 days to go and time for a little update.

Still no complications or symptoms. We're on pre-eclampsia watch now, as Jill's blood volume has dramatically increased (I think it peaks at week 28, and we're in week 25). Jill's becoming more and more anxious about the baby as time rolls by, and I'm becoming more and more anxious about the delivery. But I think much of that is normal and both of us have largely managed to keep ourselves distracted and focused on fun stuff. I painted our nursery two shades of blue with yellow stripes and installed chair rail (all Jill's vision come to life) and we've started to shop for a few critical things. Jill did a baby registry at Baby's R Us on Sunday -- eleven mostly indecipherable pages of widgets, thingamajigs, and other weird stuff. By comparison, our wedding registry in 1997 was four pages long. I have a hunch the baby supply industry has successfully pulled off some sort of vast conspiracy, but It's probably better if I keep my mouth shut.

The little guy is kicking a bit now. I got to feel a couple of them, and that was neat.

On an oddly ironic note, a good friend of mine who's due 9 weeks before Jill got uncontrollable gestational diabetes and was put on bed rest with an IV insulin drip last week. I think she'll be stuck in bed until August. I always thought it'd be us, not totally healthy friends of mine, that would have problems. We're all worried for her, but I think she'll be fine.

We still can't agree on a name. I suggested today that we just sell the baby's naming rights on eBay, figuring we could at least exploit the debate and maybe get a mention on CNN.com or some online technology rag, but the idea didn't fly.

 

[surfsparky]

Hi Christian,
You last posted 3 weeks ago, so you now must be 28 weeks. Hoping that the preeclampsaia is at bay...especially as you mentioned that it peaks at 28 weeks. Looking forward to an update,
all the best,
Yolanda (Chris' wife)