Hypertrophic cardiomyopathy and pregnancy

Women with pre-existing cardiomyopathies have limited cardiovascular reserve. The hemodynamic challenges of pregnancy, labor, and delivery pose unique risks to this group of patients, which can result in clinical decompensation with overt heart failure, arrhythmias, and rarely, maternal death. A multidisciplinary team approach and a controlled delivery are crucial to adequate management of patients with underlying heart disease. Preconception planning and risk assessment are essential and proper counseling should be offered to expectant mothers regarding both the risks that pregnancy poses, and the implications for future offspring. In this paper, we will review the hemodynamic stressors that pregnancy places upon women with hypertrophic cardiomyopathies, risk assessment and discuss what evidence exists regarding the management during pregnancy, labor, and delivery for hypertrophic cardiomyopathy.