Is pregnancy safe with a large atrial septal defect?

Question

Hello doctor,

I have a 26 mm (about one inch) large ostium secundum atrial septal defect (OS-ASD) with a left-to-right shunt. The IVC rim and superior rim appear deficient.

I would like to conceive. Is it safe for me to become pregnant with this condition?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

I am sorry to hear about your heart issue.

A 26 mm or millimeter (about one inch) ostium secundum ASD (atrial septal defect) with a left-to-right shunt is considered a large ASD. Many women with an ASD can have a successful pregnancy, but the heart must be fully assessed before conceiving because pregnancy naturally increases blood volume and workload on the heart.

The main concerns are whether

The right side of the heart is enlarged.
There is high pressure in the lung arteries (pulmonary hypertension).
There are abnormal heart rhythms.
There are signs of heart failure.

The deficient IVC (inferior vena cava) rim and superior rim are important mainly because they may affect whether the defect can be closed with a device or may require surgical closure, depending on the anatomy.

I would strongly recommend seeing an adult congenital heart disease cardiologist before pregnancy. They may advise ASD closure first, if indicated, and then pregnancy planning after confirming it is safe.

Do not assume it is unsafe, but with a large ASD, it is better to have a proper assessment before conceiving.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.