Question for Dr. Fett // Getting Tubes Tied

[tina_m]

Ok so I decided to get my tubes tied but the closer it gets (this coming Tuesday!) the more I am freaking out! I was dx in Feb. 2003 shortly after the birth of my 1st daughter. Ef was 25%. Took awhile but a few years later I got up to 58%. I got pregnant with daughter #2 (born 3/14/07) and towards the end of pregnancy ef went down to approx. 48%. My cardiologist was not concerned at all about this. I believe it was maybe 6 months after delivery I was up to 51% and now 18 months later am at 55%.

First of all, I want to confirm that it is true with each subsequent pregnancy, the risks are greater, correct? Also, is it any indication of another pregnancy being riskier being that my ef did drop under "normal" with the 2nd one or is a lower ef normal in pregnancy?

I am 28 and have 2 wonderful girls and don't really think I need anymore anyways. I just can't believe how emotional I am getting all of a sudden over it. I am just terrified at the thought of going through another pregnancy.

Tina

[JAMESFETT]

You have such a nice family, and you have had a clue from the first subsequent pregnancy what has a higher risk of happening in a second subsequent pregnancy. I would estimate your risk of relapse at approximately 50 %, and no one knows if that relapse would result in more permanent damage, but there is also a higher risk of that. You seem to have made the decision about TL some time ago, when you were able to be more objective about it. I think you have many valid reasons to trust in that decision made earlier. Maybe the most important issue to reflect upon is that IF the first subsequent pregnancy results in relapse of heart failure, however mild, then the risk of relapse with a second subsequent pregnancy is definitely higher. Best wishes now as you approach that procedure.

JD

[tina_m]

Thank you very much for your quick response. I found it very helpful. I think it has to be a difficult decision for anyone under any circumstances but I can't help feeling like I may regret it down the line. However, I do plan on proceeding with having it done.

Thanks again.

Tina