Contraception in heart failure

Women of childbearing age with heart failure should be advised to avoid pregnancy:

• deterioration of HF is seen in pregnancy due to increase in blood volume and cardiac output as well as substantial increase in extravascular fluid (1).
• maternal morbidity and mortality is high especially with severe heart failure (NYHA III-IV)
• use of low dose oestrogen and third generation progestogen preparations minimises thromboembolic complications
• if pregnancy is being considered or occurs, a specialist should be seen for further management (2)

Reference:

• (1)European Society of Cardiology (ESC) 2008. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008
• (2) National Institute for Health and Clinical Excellence (NICE) 2010. Chronic heart failure. National clinical guideline for diagnosis and management in primary and secondary care