Preconception Counseling and Contraception

Abstract

Circulatory dynamics markedly change throughout pregnancy and delivery. While many women with heart disease deliver safely, some diseases and pathological conditions are life-threatening and high risks for both mother and fetus. Thus, preconception counseling is important for safety of women with cardiovascular disease, and it is preferable to start counseling from the teenage years among women with congenital heart disease. The specialized multidisciplinary medical team, including obstetrics, adult and pediatric cardiology, anesthesiology, cardiac surgery, genetic clinic, and neonatology, is essential for high-risk pregnancy, and involvement of the team is also important in preconception counseling. Teenage years are the same timing of transitional care. As a prerequisite of counseling, it is necessary to identify whether the patient sufficiently understands their own disease and symptoms, and it is preferable to begin with an explanation of these issues when understanding is insufficient. It is important to offer the safe contraception for women with heart disease, who do not want to get pregnant, since some contraception increase the risk of thromboembolism.