Q: I had a VSD surgery done when I was 16 years old. I got married 8 years back and the doctor advised for further surgery. The second time surgery was done 6-7 years back for both VSD and AVR. I came to my senses after 17 days of the surgery due to cerebral attack at the time of surgery. My left portion was paralysed. I have been going in for physiotherapy and can walk on plain land. But I cannot do anything with my left hand. Now, I want a baby but the doctor said that it is very risky and advised us against it. I am taking Warfarin daily. Please give me a solution so I can have a baby?

A:Pregnancy in your case will be a challenge to both you and the treating physician. During pregnancy the levels of female hormones rise, causing changes in the blood vessels and the composition of the blood. Because the circulating blood volume increases, there is a higher risk of blood clotting and blood pressure may also rise, especially in the final stages of pregnancy. This rise is sometimes associated with pre-eclampsia, the high blood pressure disease of pregnancy. You are likely to have increasing difficulties with mobility, and there is the danger of falling and hurting yourself, the baby, or both. Most doctors would consider treating you with anticoagulation (heparin) during pregnancy. Warfarin is generally contraindicated during pregnancy, at least during the first trimester, due to an increased risk of birth defects. Although Warfarin does not pass into breast milk, a woman who wishes to breast feed while taking Warfarin should also consult with her physician. You need to discuss this with people at home who can help you through the pregnancy and consult a doctor who is comfortable with this situation and is willing to give time as you will require extensive monitoring. All the best.