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High Risk Effects of Pregnancy

Clearly, all of these changes may have significant effects on the heart with a congenital defect. These are most significant (considered high-risk) for CHD patients with the following:

> Elevated pulmonary artery pressures (pulmonary hypertension, pulmonary vascular disease, Eisenmenger complex)
> Reduced pump function (low ejection fraction, impaired ventricular function)
> Symptomatic valve narrowings (aortic stenosis, mitral stenosis, pulmonary stenosis, hypertrophic obstructive cardiomyopathy)
> Cyanotic heart disease (patients with a "blue" tinge in the skin due to low oxygen levels)
> Marfan's syndrome with a dilated aorta
> Mechanical artificial heart valve

Pregnancy is not recommended for individuals with certain forms of CHD. In general, these include conditions which obstruct outflow of blood:

> Marfan's Syndrome with an aortic root that exceeds 40mm in diameter
> Severe Aortic Stenosis
> Severe Mitral Stenosis
> Severe Pulmonary Stenosis
> Severe Hypertrophic Obstructive Cardiomyopathy (HOCM)
> Systemic ventricular dysfunction
> Some forms of congestive heart failure
> Severe pulmonary hypertension