Coronary heart disease and pregnancy
Coronary heart disease (CHD) occurs when a build-up of fatty deposits causes the coronary arteries, which supply your heart with blood and oxygen, to narrow. This restricts the flow of blood and can lead to chest pain when you exert yourself (called angina) or to a heart attack, where a blood clot entirely blocks one of the arteries to the heart.

In the UK there are an estimated 2 million people with angina. CHD in pregnancy is rare as it is more common in older women, aged over 50. But it is on the increase as more women become pregnant when they're older, and more women are overweight and/or smoke, both risk factors for CHD.

What are the risks?

Those who are at most risk from CHD fall into the following categories:

• if you're 35 or over
• if you smoke
• if you're overweight
• if you have a family history of early CHD
• if you have diabetes
• if you have high blood pressure

The main risk for women with CHD who become pregnant is that they'll have a heart attack during the pregnancy. Cardiac disease is the most common indirect cause of maternal death in the UK.

The risks to your baby are unknown, though some drugs that you may be taking for your CHD or related conditions such as diabetes and high blood pressure may affect your baby.

Your care during pregnancy
The best way to ensure a healthy pregnancy is to visit your cardiologist (heart specialist) before you start trying for a baby.

Your cardiologist can give you advice on which drugs are safe to take during pregnancy and may be able to adjust your treatment to minimise any risks to you and your baby. If it isn’t possible to stop taking certain drugs, your doctor can discuss the risks associated with this treatment during your pregnancy.

If you are taking aspirin for your condition it is safe to continue taking this during pregnancy. You should never stop taking any drugs without consulting your doctor or cardiologist first.

If you have had a stent inserted to stop your arteries from becoming narrowed or blocked, you will need to discuss with your cardiologist the risks to you of becoming pregnant and the best way to manage your stent during pregnancy to ensure it doesn’t become blocked.

You can prepare your body for pregnancy by doing the following things:

• lose weight if you're overweight
• stop smoking
• keep your blood pressure well controlled

During your pregnancy you should be under the care of a consultant obstetrician and a cardiologist in a maternity unit in hospital. You can expect to have more frequent antenatal check-ups, particularly if your CHD is related to other conditions such as diabetes and high blood pressure. You must ensure that you keep all your appointments or reschedule them if you have to cancel.

While you're pregnant you should:

• eat a balanced diet (find out more about healthy diet in pregnancy and foods to avoid)
• control your weight
• exercise (speak to your doctor before taking up any new exercise)
• stop smoking

Labour and birth
It is important that you give birth in a maternity unit in hospital, but there should be no reason why you cannot have a normal vaginal birth.

Find out more about hospital birth in the birth options page.