The impact of pregnancy on the woman with congenital heart disease: considerations for intrapartum nursing care.

Many women with congenital heart disease can successfully tolerate the profound hemodynamic changes associated with pregnancy and birth with a collaborative team approach to management of their disease. This article provides a discussion of the interaction between pregnancy and congenital heart disease (including left-to-right shunts, obstructive lesions, and cyanotic defects), focusing on maternal risks and strategies for intrapartum hemodynamic management. Nurses providing intrapartum care for women with congenital heart disease must understand the applicable cardiac pathophysiology, the risks imposed by pregnancy and the birth process, and appropriate medical and nursing interventions to prevent complications.