Patent Foramen Ovale: A Common Heart Anomaly in Pregnant Women

In previous articles on The Pulse, we have covered the rare but serious complication of strokes occurring during pregnancy, resulting from increased tendency to form blood clots, and we have also touched on the topic of congenital conditions leaving a hole between the two atria (upper chambers) of a baby’s heart. Hearing about such congenital heart malformations, you may think of young children automatically. After all, congenital conditions are the may issue that concern us when it comes to newborns, as they are born and develop into young children. But today, let’s explore what happens when the baby with the The post Patent Foramen Ovale: A Common Heart Anomaly in Pregnant Women appeared first on The Pulse.

Patent Foramen Ovale: A Common Heart Anomaly in Pregnant Women

In previous articles on The Pulse, we have covered the rare but serious complication of strokes occurring during pregnancy, resulting from increased tendency to form blood clots, and we have also touched on the topic of congenital conditions leaving a hole between the two atria (upper chambers) of a baby’s heart. Hearing about such congenital heart malformations, you may think of young children automatically. After all, congenital conditions are the may issue that concern us when it comes to newborns, as they are born and develop into young children. But today, let’s explore what happens when the baby with the most common type of structural heart issue, a type of hole known as a patent foramen ovale (PFO) grows up and sets out to have children of her own. We are choosing to focus on PFO as today’s example, because it is extremely common. It occurs in an estimated 25 to 30 percent of people; that’s so common that we cannot even refer to PFO as a disease.

Before considering PFO in the context of pregnancy, let’s take a look at how to classify PFO in relation to what is normal and what is not. A hole between the two atria of the heart can be either an atrial septal defect (ASD), meaning that a portion of the the atrial septum (the wall between the two atria) is simply missing. This can happen in an adult either from a very bad heart attack that damages the septum, which is extremely rare in a woman of childbearing age, or, in almost all cases, as a result of the interatrial septum never completing its formation in the first place, that is during fetal life. Much, much, much, more common, however is a PFO, which is different from an ASD that way that broken door is different from a hole in the wall of your house. During fetal life, right up to birth, a part of the interatrial septum has a kind of swinging door, on an opening through the septum, called the foramen ovale. Have you ever seen an old western movie in which some guy walks into a saloon, busting through swinging doors, that move back and forth in both directions? Well, that’s not the type of swinging door that you have in your heart. Think instead about the kind of swinging door that can swing only one way, either into or out of a room. In the heart, between the right and left atria, the door through the foramen ovale swings in the direction toward the left atrium. Consequently, when you were a fetus and your lungs were all collapsed and full of fluid, keeping the pressure in the lungs high, the pressure in your right atrium was high, higher than the pressure in your left atrium. This kept the foramen ovale open, allowing blood to move freely from the right side of the heart to the left. When you were born however, and took your first breaths of air, the lungs inflated, the pressure in the right atrium decreased dramatically, while the pressure in the left atrium increased, leading to the post-birth circulatory situation, characterized by a high pressure on the left side of the heart and a low pressure on the right side.

Now, in most people, over the course of weeks to months, the swinging door of the foramen ovale, not only stays shut because of the higher pressure in the left atrium pushing it shut, but also because locks shut. Actual physical connections form, making it more like a locked door than like a swinging door. But in those 25-30 percent of people, the door never locks, which means that it could swing open on some occasions —namely, when the pressure in the right atrium increases significantly compared with the pressure in the left atrium. When might such a pressure change occur in a pregnant woman?

First of all, it happens whenever the volume of blood entering the right atrium increases, and that happens during pregnancy. As pregnancy progresses, the volume of blood in a woman increases typically about 50 percent and in some women the increases can even approach 100 percent. Increased right atrial pressure also could happen during SCUBA diving — which is not something that you are not supposed to do while you are pregnant— but there is something that everybody does, whether pregnant or not. It’s called a Valsalva maneuver, a sudden increase of pressure in your thorax against a closed glottis. This happens when you cough, laugh, or strain to go to the potty number two and also in certain very high stress situations, when you need to raise the pressure in your abdomen and thorax and keep it high for moments at a time, such as when you lift something very heavy (which you shouldn’t do while pregnant), or when prevent yourself from losing consciousness while flying a high performance aircraft through a high acceleration maneuver (which also is not recommended during pregnancy).

Or, when you push during vaginal delivery, to get the baby out. This is the situation that worries people and may lead your obstetrician to recommend cesarean birth, but the good news is that, despite the very high prevalence of PFO among healthy adults, many PFOs produce only very mild changes in the types of things that could cause a problem. Consequently, the simple presence of a PFO, as opposed to certain more serious cardiac anomalies that we’ll discuss in future posts, may not put you at serious risk, nor necessitate that you have a C-section, although the option would be open to you.

So what types of changes and problems are we concerned might result from an increased pressure in the right atrium pushing open the swing door? The main issue is that it could lead to a stroke, due to blood from the right atrium moving directly into the left atrium, thus bypassing the lungs. Such a stroke would be initiated by an embolus reaching the brain and causing an embolism, after breaking off from another clot, either in a deep vein, or in the heart itself. The first scenario, an embolus coming from a clot in a deep vein, is something that we have discussed previously on The Pulse, and for which pregnant women are at particular risk. The second scenario, an embolus from the heart itself, can result from what doctors call an atrial septal aneurysm, which can occur in association with a PFO, or more likely with an ASD.

The presence of any of these structural heart conditions —PFO, ASD, atrial septal aneurysm— can be determined with a technique called cardiac ultrasonography, which works on your heart just like the ultrasonography that is used on your uterus to examine your fetus. While most PFOs are very mild and do not require treatment during pregnancy, more severe cases can be treated using instruments that are passed through blood vessels to close the opening in the atrial septum without surgery.

The post Patent Foramen Ovale: A Common Heart Anomaly in Pregnant Women appeared first on The Pulse.

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Baby’s nursery must haves from Babies R Us!

NextBabies R Us are back and better than ever! Drawing on their rich history and experience in retail for both babies and kids, they’ve got a brand-new site that is guaranteed to be your new go-to baby store! With a large offering, including baby food, nappies and changing supplies, feeding accessories and strollers, Babies R […] The post Baby’s nursery must haves from Babies R Us! appeared first on Newborn Baby.

Baby’s nursery must haves from Babies R Us!

Babies R Us are back and better than ever! Drawing on their rich history and experience in retail for both babies and kids, they’ve got a brand-new site that is guaranteed to be your new go-to baby store!

With a large offering, including baby food, nappies and changing supplies, feeding accessories and strollers, Babies R Us have your needs covered from pregnancy, right through to birth. New styles are added daily, showcasing current leading brands and premium products from all around the world.

We are here to make your time navigating their product offering just that little bit easier. So here is a list of “nursery must haves”, the essential, functional and stylish items every nursery is yearning for.

Love N Care Dreamtime Sleeper – Charcoal

The Love N Care dreamtime Sleeper has both a bassinet and bedside co-sleeper mode. This allows you to sleep next to your baby safely in the first few months.

Key Features Include:

  • Sleeper attaches to Parents’ bed using straps
  • Soft padded sides for extra comfort
  • Can be inclined at either end using the height positions individually adjustable on each side
  • Simple to assemble and use
  • Tilt-adjustable (help against reflux)

RRP: $429.00

Oricom OLS50 Portable Sound Soother

The cute but practical Oricom Portable Sound Soother and Night Light provides your bub with soothing sounds. It includes adjustable settings and a portable design to ensure a personalised ambiance for your little one whether at home or on the go.

Oricom OLS50 Portable Sound Soother

Key Features Include:

  • Portable sound soother with an adjustable strap for ideal mounting position
  • Built in lullabies, white noise, shusher and nature sounds
  • Adjustable volume control
  • Timer function (30mins/60mins/off)
  • Low battery alert
  • 2 x AA batteries (not included)

RRP $39.95

Tommee Tippee Twist and Click Sangenic Advanced Nappy Disposal Bin System

The Twist and Click Sangenic Tee nappy disposal system from Tommee Tippee offers innovative and swift anti-bacterial protection from germs and odours, individually sealing each nappy away in seconds. The system is not only easy to set up but also very easy to use and empty – meaning less time changing and more quality time with your bub.

 Tommee Tippee Twist and Click Sangenic Advanced Nappy Disposal Bin System

Key Features Include:

  • Bin that individually seals each nappy for an odour block like no other
  • Antibacterial multi-layer film kills 99% of germs
  • Less film used each wrap, creates less waste
  • Holds up to 28 nappies

RRP $59.95

Tommee Tippee Groegg Room Thermometer

Tomee Tippee have created a modern and unique nursery thermometer that provides instant safety reassurance. The Groegg, with its colour-changing settings, remind you to change the baby’s bedding, clothing or make adjustments to the room temperature if required. A nursery essential for all new parents!

Tommee Tippee Groegg Room Thermometer

Key Features Include:

  • Easy to understand colour coded system which indicates room temperature
  • Digital thermometer with back-lit LCD display
  • Gentle nightlight glow
  • USB powered (adaptor included)
  • Height 10.6cm

RRP $49.95

Bugaboo Fox 2 Complete Pram – Grey Melange

With 20 years of the latest Bugaboo innovation and technology behind this design, the Fox 2 Complete Pram is the perfect ultra-lightweight drive with power steering, making it the perfect pram for all occasions.

Babies R Us

Key Features Include:

  • Central joint and front-wheel suspension
  • Sun canopy with peekaboo window and breezy panel
  • Large, easily accessible understand basket with storage pockets, perfect for lockdown park visits
  • Height adjustable handlebar

RRP: $1,999.00 limited time only – on sale $1499!

ergoPouch Sheeting Sleeping Bag 0.3 TOG Night Sky

The Sheeting Sleeping Bag is designed for arms out sleepers (usually from around 3 months of age) who prefer a roomier fit whilst in their pouch. Safe-sleep approved, this ergoPouch is made from a 400 thread count organic cotton creating a smoother and more comfortable feel on your baby’s soft skin.

ergoPouch Sheeting Sleeping Bag 0.3 TOG Night Sky

Key Features Include:

  • GOTS certified organic cotton
  • Breathable Natural Fibres
  • 400 Thread Count
  • Arms-out sleeping

RRP $59.95

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