Care Of The Heart During Pregnancy
( Originally Published 1921 )
THE importance of this may not be over looked, for accidents from heart trouble in women are not at all infrequent during the child-bearing period. The obstetric physician often concentrates his attention too closely on his own department.
It was my good fortune, in the years before I devoted myself exclusively to disease of the heart, to have combined medical and obstetrical wards, and since that time not a few serious heart patients have been observed during pregnancy and child-birth.
Nature is kind to a child-bearing woman in its provision of extra strength for all the organs; the heart is no exception to this, and becomes larger and stronger to carry the additional circulation required, but a physician should not rely entirely upon this provision of nature in those with weak hearts ; they should be given special treatment and management.
Another reason why this question should be examined in a judicial manner is that one is often asked whether marriage is attended with risk; and tho advice is seldom followed, one should be in a position to discuss the matter intelligently. When there is a serious valvular trouble, the danger is comparatively great ; but in cases of simple weakness, by a course of treatment during the child-bearing period, the heart may be strengthened and everything come out happily. I have known at least one instance where the faithfulness of a nurse in carrying out instructions enabled a woman to live when without such care I can not see how she could have survived.
Care during the whole period of pregnancy is much better for the patient than attention given only in emergencies. Any shortness of breath should draw attention to the heart, and a regimen entailing proper diet, exercise, and perhaps a series of carbonated baths, according to the Nauheim methods, should be instituted. I have seen the happiest results from the Nall heim treatment of heart trouble during pregnancy, but of course such a treatment must be carried out with the greatest good judgment.
Women have long been taught to submit to the physician at regular intervals samples of the urine, to determine the healthfulness of the kidneys ; but observation of the condition of the heart has been strangely neglected, tho it is often equally important. The experienced physician will know the degree of shortness of breath, swelling of the feet, and tenderness of the liver which is natural to the expectant mother, and any slight increase will lead him to suspect that the heart is not quite equal to the burden put upon it.
Experience seems to show that neglected heart trouble during pregnancy is not surely followed by recovery. Therefore treatment should not be postponed with the idea that things will right themselves.