Pregnancy Management and Outcomes with Hypertrophic Cardiomyopathy

<h2>Abstract</h2> Hypertrophic cardiomyopathy (HCM) is a common inherited genetic cardiac disorder that is increasingly being diagnosed in people of childbearing age due to advancements in genetic testing and the evolution of screening guidelines. Many women may first present with HCM during pregnancy, which can lead to adverse maternal and fetal outcomes if not appropriately managed. While most women with HCM tolerate pregnancy well, it can be associated with increased cardiovascular risks, including heart failure, arrhythmias, and adverse fetal outcomes, particularly among those with suboptimal baseline functional status. Medical therapy remains the mainstay of management of HCM in pregnancy, as there are limited studies on the safety and effectiveness of invasive procedures such as alcohol septal ablation and cardiac myomectomy in pregnant women. There is a paucity of large cohort studies of women with HCM and management practices vary within centers with no protocolized care. This review aims to summarize the unique challenges faced by pregnant women with HCM, highlighting the need for large multicentric studies and more standardized care protocols in order to optimize maternal and fetal outcomes.