While a normal heart may be able to take this work load, a diseased heart may not be able to cope as well. Most heart diseases are present before pregnancy, some becoming worse and some manifest for the first time.
Valvular disease leads the way, being the most common heart disease in pregnancy.
When the patient is stable no special treatment is needed. When there are signs of hemodynamic compromise, careful fetal monitoring is needed. Clinical and ultrasound examinations can assess fetal growth and amniotic fluid volume. Other tests that may be required are cardiotocography to measure fetal heart rate, color doppler flow studies to measure fetal and maternal placental blood flow, fetal blood sampling to detect low oxygen content. If heart failure develops, the principle treatments remain the same, with dogoxin and diuretics being the cornerstones of therapy.