My patient, who I’ll call Sarah, was in heart failure. She developed peripartum cardiomyopathy following her last pregnancy and delivery of her youngest child, and her heart function declined so much, she was placed on a heart transplant list.

While awaiting her transplant, Sarah was given a device that kept her heart pumping, and was placed on life-long teratogenic medications. During this same tumultuous time period, she conceived.

Not only was the pregnancy threatened by the medications this woman was taking, the growing pregnancy would threaten to dislodge the cardiac assist device (LVAD) out of place. But more importantly, the pregnancy would further deteriorate the cardiac function, and with every week of growing pregnancy, Sarah’s life was threatened. Sarah wanted to live and wanted to receive her heart transplant.

Her cardiac team and her maternal fetal medicine doctors coordinated a very safe and quick termination procedure, so that Sarah’s life would not be further threatened by her unintended pregnancy.