Key points to remember about pregnancy and heart health after childhood cancer

This page is written for young people who have had cancer treatment.

• if you had anthracyclines or high dose chest irradiation, make sure your maternity carers know what treatment you received
• make sure your maternity carers have a copy of your treatment summary
• most young women do not have any problems but your healthcare team may need to check your heart during pregnancy

What happens to the heart during pregnancy?

You might like to first read Your heart after childhood cancer [1].

During pregnancy and labour the heart needs to work much harder. The blood volume increases by 30 to 50 percent and the amount pumped by the heart every minute (cardiac output) increases by up to 30 to 40 percent. The size of the heart increases to cope with the extra demand on it. Even if your heart has been fine, this is a time when problems could develop.

If you had anthracyclines or high dose chest irradiation, make sure your maternity carers know what treatment you received. Also, make sure your maternity carers have a copy of your treatment summary. This is sometimes called a 'health passport'. Most young women do not have any problems but your healthcare team may need to check your heart during pregnancy.

Current recommendations about pregnancy and your heart after childhood cancer

Tell your maternity carers about the treatment you received.

Echocardiogram

If you have had an echocardiogram before becoming pregnant and this was normal, no further routine scans are necessary. If not, then you should have an echocardiogram during the first 3 months. If you develop shortness of breath, unexpected tiredness (fatigue), blood pressure changes or ankle swelling, then you need another echocardiogram. It may be necessary for you to see the high-risk maternity team.

If you had very high dose anthracycline or chest irradiation, your health provider may also recommend that you have repeat echocardiograms in pregnancy.

Specialised care

Your healthcare team may advise you to include a medical doctor (obstetrician or GP) in your care. This can be either instead of, or together with, a midwife. Your GP or Late Effects Assessment Programme (LEAP) team can refer you to the local hospital maternity service where specialised care is free.

Hospital birth

Make sure your maternity carers have a copy of your treatment summary.

Your healthcare team may suggest a hospital birth rather than a home birth if they think you are high risk.

Checking your heart during each pregnancy after childhood cancer