Case studies of the perceptions of women with high risk congenital heart disease successfully completing a pregnancy.

PURPOSE: Women even with moderate to severe congenital heart disease (CHD) seek motherhood despite posing significant health risks to themselves and their infant. This study explored their motivations and perceptions and compared them to those of women with low risk CHD who conceived. PROCEDURES: Twenty women over 18 years with CHD who had a successful pregnancy were recruited, half of whom were identified as having a high risk cardiac abnormality. They completed a questionnaire and a semi-structured interview following which a thematic analysis was employed. Their medical records and clinical status were also reviewed and their current cardiac status graded by their attending cardiologist. FINDINGS: Women with high risk (moderate to severe) CHD (n=10) appeared to have similar motivations for conceiving as women with low-risk (mild) CHD (n=10). Their decision to conceive seemed based on their own and at times unrealistic perceptions of the consequences of their CHD. CONCLUSIONS: Women with mild or more severe CHD had similar motivations to conceive tending to down play the seriousness of their CHD. Their drive for motherhood appeared to be stronger than the drive for self care. It behoves clinicians, both obstetricians and cardiologists caring for women with high risk CHD to be knowledgeable of the effects of the CHD on the pregnancy and the impact of the pregnancy on the cardiac status.

Perceptions and motivations of an Australian cohort of women with or without congenital heart disease proceeding to pregnancy.

OBJECTIVE: To assess the perceptions of women with congenital heart disease (CHD) regarding the severity of their cardiac abnormality and its implications in pregnancy, and whether their motivations to conceive were similar to those of women without CHD. METHODS: A retrospective descriptive study of a cohort of women with (n = 20) or without (n = 20) CHD, aged over 18 years, who had had one or more successful pregnancies. The women were surveyed using a semi-structured questionnaire and their medical records were reviewed. Data were analyzed using thematic analysis. RESULTS: Women with CHD were concerned about the health risks associated with their CHD; however, they were not deterred from conceiving because 10 out of 20 women had a tendency to downplay the seriousness of their CHD. The women's motivations to conceive were similar in both groups. CONCLUSION: Although women with CHD were clinically identified as an at-risk group, with possible health complications for themselves and their infant, it was ultimately the women's inaccurate perception of the severity of their CHD and of the associated potential health risks that influenced their decision to pursue motherhood. This emphasizes the need for clinicians to have detailed knowledge of the cardiac abnormality and its implications in pregnancy.