New Here! Could use some info on pregnacy with mild AI

[acbehnke]

Hello everyone. I just happened to find this site and I am glad I did. Lots of great support and information.

Here is my situation and I am hoping someone out there has had a similar one.

I was diagnosed about 2 1/2 years ago with a bicuspid valve with mild AI. At this point in the game, my doctor says that it could still be 20 years down the road before surgery is necessary for me. About the only symptoms I have right now are some shortness of breath when I climb a bunch of stairs or am really active. I am now 35 years old and my husband and I are discussing getting pregnant (we have a 4 year old daughter).

I have talked to my doctor and a good friend of mine who is a Cardiologist, and both have assured me that it would be perfectly safe for me and the baby, to get pregnant, carry to term . Basically they have told me that I would just have to be monitored more closely.

My concerns are not so much during the pregnancy, but with the labor/delivery part and after giving birth, will it put too much stress on my heart? Will my condition worsen more quickly than it would have if I don't get pregnant? Will I pass this along to my children?

I would appreciate anyone's advice or personal stories on this. I know each individuals experiences are different, but it is nice to know all the possibilities and scenerios, so I can make a good solid deceision.

Thanks, look forward to your help.
Amy

 

[Susan BAV]

Hi Amy -

Welcome to the site; glad you found it. There are quite a few of us who had babies with a bicuspid but I was fairly young and I don't know how stenosed or anything my bicuspid was when I was pregnant; maybe it wasn't very bad then. I had been told by one well-meaning doctor, many years ago when I was first engaged, that I shouldn't have children. But happily for us, we did anyway. What do your doctors say?

I was ill and exhausted and slept through most of the first pregnancy and the doctors did monitor me closely. You could also access the Search feature here on this site and type in pregnant and pregnancy and perhaps you'll see more experiences.

But hopefully others will post also. It's kind of a difficult subject. The health of the mother is one issue but another is because bicuspids tend to run in families. I happen to be the only known bicuspid in my extended family. I posted a question here quite some time ago about whether those with bicuspids had smoking parents; and from the replies here, parental nicotine use was an extremely common factor for those born with bicuspids.

Take care and please post again.

 

[acbehnke]

I haven't spoken to my doctor yet, only his nurse, who seemed to think that it should be no problem whatsoever for me. She said I would need to speak with my OB and he could determine how often he would like for me to checked out by my cardio', but that I should first have another echo done to make sure there have been no changes since my last echo and that I would be monitored more closely during the pregnancy. She said the only physical symtoms I may have was more shortness of breath. I have not spoken with my OB yet to see what his feeling is.
I was not diagnosed with the BV until my daughter was almost 2 years old, so I cannot really judge how if affected me last time, if at all. I do remember sometimes needing to just take a really big breath in, it was a little hard to breathe occasionally. I also was not able to have an epidural because my platelettes (?) were too low. Anyone know what causes that? I wonder now if my AI had anything to do with that.
It just seems to me that all the extra stress that the pregnancy and labor put on my heart may have brought on my symptoms and I worry about going through all of that again.

I have an appointment this week with my family doctor, who has to refer me to my OB. I am waiting to speak with him before we make any final deceisions. If he thinks that it will be okay then I am going to make an appointment with my cardio' for an echo and if things still seem to be unchanged, we will probably just leave it up to the good lord to deceide. My husband is leaving for deployment to Iraq in January, so if we don't get prego' by then, then we will just forget about it.
Aside from the fact of my heart, I worry about my age and all the complications and risks that arise after the age of 35.

Thanks again.

 

[Karlynn]

Welcome Amy! I think the easiest answer to your question is that no one really knows what will happen. My Mitral Valve Prolapse with regurge (mild to moderate) was dx'd when I was 22. I had a miscarriage at 24, my first child at 25. I had no problems with what so ever that were heart related. I didn't even give it much of a thought at all. When I got pregnant with my daughter a year and a half after my son was born my valve "tanked" and I became very symptomatic with that pregnancy. I had no symptoms (that I know of) prior to the 3rd pregnancy. I only new of my valve situation due to the diagnosis. I didn't have the valve replaced for 5 years, mainly due to the fact that this was 20 years ago and they weren't rushing into valve surgery on 27 year-olds. In hind sight, it should have been replaced much sooner. There are several members here who had valve problems arise with pregnancy. With some it's their first, with others, it's their 5th.

If you are in very good health, not symptomatic from your AI, I would suggest going with the recommendations from you cardio and a high-risk OB.

A cardio can tell you you're 20 years away from a valve replacment and then find that in 3 years you're on the table. No one can really predict just when a valve will decide to worsen.

I wish you the best as you explore your options.

 

[Arlyss]

Information about Bicuspid Aortic Valve

Information about Bicuspid Aortic Valve

Although this medical paper from the U of Toronto gives an example of a man with a BAV, not a woman, it does give a very good overview of bicuspid aortic valves and what they can mean in the body. Specifically, the aorta can also be affected and should be assessed for enlargement/aneurysm.

http://circ.ahajournals.org/cgi/content/full/106/8/900

What is important for you to know is the condition of your aorta, as well as your valve.

I do not want to frighten anyone - many women do have pregnancies never knowing that they have a BAV. However, if your BAV is begining to leak, the valve tissue is already showing signs of abnormality, and the aorta should be looked at also.

Best wishes,
Arlyss

 

[acbehnke]

Thanks for the article Arlyss.
I knew going into this there were going to be lots of things to consider. I feel somewhat comfortable that I will be just fine, but I want to make sure that I explore every possibility here. It is much more important to me to be a healthy mom for my daughter as long as possible than to put myself in a situation of having two kids and facing valve replacement surgery earlier than I anticipated.

Everyone have a great day!

 

[Lisa in Katy]

Remember this - even though you weren't aware of it, you already had the heart problem with your first pregnancy, so it shouldn't be much different.

My problem was with my mitral valve, caused by Rheumatic Fever when I was 14. I had my first baby at 28 and my second at 31. I will say that the doctor didn't recommend it, but I felt at the time it was just a case of CYA. Like you, I was mostly symptom free, even though my regurg was severe. My first pregnancy was textbook perfect and my blood pressure was lower than ever. From the beginning, the plan had been to closely monitor and do a C-section, if necessary, any time after week 32. Luckily, it wasn't necessary and I delivered with an epidural. My second pregnancy had some complications, but none had to do with my heart - diabetes, amniotic band. My blood pressure did go up at the end of term, but not dangerously high - actually not much higher than it was when I wasn't pregnant - and I'd had lots of contributing factors that may have caused it (complications mentioned earlier, husband laid off, mother had a grand mal seizure and was hospitalized, grandmother died, we bought and moved into our first house).

The best recommendation from my cardiologist after I became pregnant was, "Don't gain any more weight than you have to. The more you gain, the harder it is on your heart, and it's already like playing a 9-month long game of slow basketball." I did follow up with my cardiologist throughout both of my pregnancies, and in my second one, the cardiologist monitored me throughout delivery. I think this had more to do with living in Houston, where everything is high-tech, as opposed to Lafayette, LA, where I delivered my first.

As far as passing it on to your child, I'm sure others can answer better than I. My brother had a bicuspid aortic valve, and as far as we know, no one else in my family had this, and neither do either of his children.

 

[Ericalwhite]

Pregnancy Info

Pregnancy Info

Hi Amy

Your situation sounds a bit similar to mine though i was diagnosed at birth.

My two pregnancies didn't really have much affect on my valve. Before i got pregnant my valve was still in good enough condition to not need to be replaced and post pregnancy there really wasn't much change. I did have a c-section my first time after 14 hours of labor and decided not to opt for a VBAC after that so both were cesarian. But my valve/heart did fine through all of it.

One year after my last delivery i started a more-reginmented work out program than i ever had before. I always held back on excersise per doctor's orders and wanting to keep my own valve as long as possible until after my kids were born. Two years after that my cardiologist said my valve had had enough and needed to be replaced. Probably could have gotten it to last longer if i hadn't pushed the running thing so hard but i just needed to do it to make myself feel better after the second pregancy.

If there is any more info i can share i'd be happy to. Good luck!

 

[Caroline2007]

Hi Amy -

I was diagnosed at birth with BAV and was never restricted. Had a baby at 30 and one at 31 with the stenosis being still mild, and saw my cardiologist during. After my 3rd child at 35, I was progressed into moderate. It took 5.5 years to develop into severe (I had an AVR in June). So if you are mild, a pregancy should be ok with your cardiologist monitoring.

During my 2nd and 3rd pregnancies, I went to a pediatric cardiologist who did an ultrasound of the babies hearts and found no issues. For some reason, after my surgery I was really worried about my first born, since the heart ultrasound was not done on him. I called the pediatric cardiologist and ask, but they said they would not worry about it unless a murmur was detected.

I hope it all goes well with you and your family. My thoughts and prayers go out to you and your husband as you deal with this and his upcoming deployment. My deepest respect for him.

- Caroline

 

[Arlyss]

A Reference from the Medical Literature

A Reference from the Medical Literature

This paper from Switzerland discusses what they observed about aortic dissection, pregnancy, and BAVD.

http://www.ncbi.nlm.nih.gov/sites/e...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Regardless of whether or not the BAV has been replaced, pregnant or not, every one born with BAV should know the status of their aorta - a great topic for discussion with your doctors. If they are not aware, another helpful reference for them is the 2006 guidelines for heart Valve Patients - here is that link also

http://content.onlinejacc.org/cgi/content/full/48/3/e1?ct

There is considerable variation regarding when BAV disease may affect someone, as well as how. Looking inside avoids surprises and today's technology makes that possible.

Best wishes,
Arlyss

 

[acbehnke]

Thanks so much everyone. Lot's of encouragement here. I really look forward to my appointment with my Cardiologist and see what my newest echo looks like. I am just thankful that I know of my condition this time around and I can take all the precautions I need to and have all the information I need to make a safe decision.

Thanks for the prayers as well. I know I can always count on those.
I am pretty proud of my hubby!