HELLO & WELCOME TO HCM FORUM YOU HAVE NOT MENTIONED YOUR DISEASE ..WITHOUT EXAMINING ITS VERY DIFFICULT TO COMMENT ANYTHING I AM GIVING YOU BREIF CONDISDERING YOU ARE SUFFERING FROM ATRIAL SEPTAL DEFECT/ VENTRICULAR SEPTAL DEFECT 1) PATIENTS WITH PREEXISTING CARDIAC LESIONS SHOULD BE COUNSELED IN ADVANCE ABOUT THE RISK OF PREGNANCY. 2) DURING LABOR AND DELIVERY, HEMODYNAMIC FLUCTUATIONS CAN BE PROFOUND. EACH UTERINE CONTRACTION DISPLACES 300 TO 500 ML OF BLOOD INTO THE GENERAL CIRCULATION. STROKE VOLUME INCREASES, WITH A RESULTANT RISE IN CARDIAC OUTPUT BY AN ADDITIONAL 50% WITH EACH CONTRACTION. THUS, IT IS POSSIBLE FOR THE CARDIAC OUTPUT DURING LABOR AND DELIVERY TO BE 75% ABOVE BASELINE. MEAN ARTERIAL PRESSURE ALSO RISES, IN PART BECAUSE OF MATERNAL PAIN AND ANXIETY. BLOOD LOSS DURING DELIVERY (300 TO 400 ML FOR A VAGINAL DELIVERY AND 500 TO 800 ML FOR A CESAREAN SECTION) CAN CONTRIBUTE TO HEMODYNAMIC STRESS. 3) HEMODYNAMIC CHANGES DURING THE POSTPARTUM STATE ARE EQUALLY DRAMATIC. RELIEF OF INFERIOR VENA CAVAL COMPRESSION RESULTS IN AN INCREASE IN VENOUS RETURN, WHICH AUGMENTS CARDIAC OUTPUT AND CAUSES A BRISK DIURESIS. THE HEMODYNAMIC CHANGES RETURN TO THE PREPREGNANT BASELINE WITHIN 2 TO 4 WEEKS FOLLOWING VAGINAL DELIVERY AND WITHIN 4 TO 6 WEEKS AFTER CESAREAN SECTION. 4) BOTH ATRIAL/ VENTRICULAR SEPTAL DEFECT ARE CONSIDERED LOW RISK HEART CONDITION. 5) YOUNG WOMEN WITH UNCOMPLICATED SECUNDUM-TYPE ATRIAL SEPTAL DEFECT (ASD) OR ISOLATED VENTRICULAR SEPTAL DEFECT (VSD) USUALLY TOLERATE PREGNANCY WELL. 6) HOWEVER, THE PRESENCE OF PULMONARY HYPERTENSION WITH A LEFT TO RIGHT SHUNT SUBSTANTIALLY INCREASES THE RISK OF COMPLICATIONS DURING PREGNANCY. 7) THE AMERICAN HEART ASSOCIATION NO LONGER RECOMMENDS ANTIBIOTIC PROPHYLAXIS FOR THE PREVENTION OF BACTERIAL ENDOCARDITIS DURING GENITOURINARY PROCEDURES, SUCH AS VAGINAL DELIVERY AND CESAREAN SECTION, INCLUDING HIGH-RISK PATIENTS. 8) YES CEASEREAN SECTION IS PREFERRED BY GYANECOLOGIST IF A FEMALE IS SUFFERING FROM HEART DISEASE AS THIS WILL PREVENT EXCESSIVE LOAD ON HEART. 9) AT 35 WEEKS AND 3 DAYS YOU CAN EASILY UNDERGO FOR CEASEREAN SECTION AND TAKE CONSULTATION WITH YOUR DOCTOR TAKE CARE DR. MAYANK BHARGAVA