Managing POTS Symptoms During Pregnancy - Tips for a Healthy Pregnancy

Understanding POTS and Pregnancy

Pregnancy can be both an exciting and challenging time for any woman. However, for women with postural orthostatic tachycardia syndrome (POTS), pregnancy brings its own unique set of concerns and considerations. POTS is a condition that affects blood flow and causes an abnormal increase in heart rate and lightheadedness when standing up. This can make pregnancy especially difficult. However, with proper preparation and management, many women with POTS are able to have healthy pregnancies.

How POTS Affects Pregnancy

There are several ways that POTS can impact pregnancy:

• Exacerbation of symptoms - Many women find their POTS symptoms get worse during pregnancy due to hormonal changes and the physical demands of pregnancy on the body.
• Fatigue - Fatigue is a common symptom of POTS and is also very common during pregnancy, so women may experience extreme tiredness and impaired stamina.
• Orthostatic hypotension - The blood vessel dilation and hormonal changes of pregnancy can make low blood pressure worse in those with POTS.
• Fainting - Some pregnant women with POTS experience an increase in fainting episodes due to unstable blood pressure.
• Dehydration - Maintaining hydration can be difficult for those with POTS, and dehydration during pregnancy increases risks.
• Impaired circulation - POTS affects circulation which can potentially impact blood flow to the uterus and placenta.

In addition to physical symptoms, POTS may also contribute to increased stress, anxiety, and depression during pregnancy. Proper planning and management is key to minimizing complications.

Tips for Managing POTS During Pregnancy

There are several things women with POTS can do to help have a more comfortable and low-risk pregnancy:

• Stay hydrated - Drink plenty of electrolyte-rich fluids like sports drinks or coconut water. Hydration is especially important in POTS and pregnancy.
• Increase salt intake - To help retain fluids and avoid low blood pressure, consume salty foods or supplements.
• Try compression garments - Compression stockings or abdominal bands can help prevent blood from pooling in extremities.
• Take frequent breaks - Avoid staying on your feet too long and rest in left-side lying to maximize blood flow.
• Exercise regularly - Low-impact activity can help mitigate POTS symptoms but avoid overexertion.
• Raise the head of your bed - This helps prevent nighttime low blood pressure and dizziness upon standing.

Additionally, working closely with your healthcare provider for extra monitoring and specialized care is highly recommended. Ask for accommodations at work or school as needed to help reduce fatigue.

POTS and High-Risk Pregnancy Concerns

Some specific pregnancy complications and risks to be aware of with POTS include:

• Low birth weight - Poor placental blood flow could restrict the baby's growth.
• Preterm delivery - Dizziness and fainting may provoke early labor.
• Preeclampsia - High blood pressure disorders are more common with POTS.
• Excessive nausea - Morning sickness can be aggravated by low blood pressure.
• Blood clots - Dehydration and poor circulation increase clotting risks.
• SIDS - Infants of mothers with POTS appear to be at higher risk for sudden infant death syndrome.

To minimize these risks, additional fetal monitoring, more frequent doctor visits, and earlier delivery may be recommended. Bed rest and hydration are also commonly advised to support a healthy pregnancy.

POTS Medications and Pregnancy

Many standard medications used to treat POTS are considered relatively low-risk during pregnancy. However, always discuss medication use thoroughly with your doctor.

Some POTS medications generally considered safe in pregnancy include:

• Propranolol (beta blocker)
• Pyridostigmine
• Midodrine
• Fludrocortisone
• Selective serotonin reuptake inhibitors (SSRIs)
• Intravenous immunoglobulin (IVIG)

Medications that are typically avoided or should be used with caution during pregnancy include:

• Methyldopa
• Clonidine
• Diuretics
• Stimulants like amphetamines

Always weigh the risks and benefits of any medication during pregnancy. Stopping medications abruptly can also be harmful. Finding alternative treatments like electrolytes, compression garments, and lifestyle adjustments may allow some women to minimize medication use during pregnancy.

Giving Birth with POTS

Labor and delivery can present additional challenges for mothers with POTS but there are ways to help things go more smoothly:

• Have plenty of fluids and snacks during labor to maintain blood sugar and hydration.
• Use positions like side-lying or semi-reclining to prevent blood pressure drops.
• Have compression garments ready for use after delivery.
• Take it slowly when standing up after birth to prevent fainting.
• Discuss epidural anesthesia with your doctor to balance pain relief with blood pressure concerns.
• Consider a planned C-section with extra monitoring if symptoms are very uncontrolled.

Anesthesia and postpartum monitoring times may need to be extended for women with POTS. Having supportive care from your healthcare team is key.

Caring for a Newborn with POTS

Many new mothers with POTS become apprehensive about their ability to adequately care for a newborn. However, some simple adaptations can help:

• Accept help from loved ones with infant care tasks when possible.
• Sit down while feeding, changing, or rocking baby to conserve energy.
• Use baby carriers to keep baby close while keeping hands free.
• Prepare and freeze healthy meals ahead of time when you have the energy.
• Take advantage of naptime to rest when the baby sleeps.
• Recruit family to bring you water, snacks, and electrolytes throughout the day.
• Take occasional 10-15 minute breaks throughout the day to recline and drink fluids.

With proper preparation and support, most mothers with POTS find that maternal instinct kicks in and they are able to thrive and meet their newborn's needs. Don't be afraid to ask for help and take time to recharge.

The Outlook for Pregnancy with POTS

Pregnancy with POTS certainly presents some additional concerns and considerations. But with a knowledgeable healthcare team, proper planning, and lifestyle adaptations, many women with POTS are able to achieve relatively normal pregnancies and deliver healthy babies.

Open communication with your doctors is key. They can help monitor and manage your symptoms, provide coaching on minimizing risks, and reassure you when concerns arise. Joining POTS support groups can also provide helpful advice from other mothers who have been through it.

Perhaps most importantly, listen to your body and don't overload yourself. Accept extra help from loved ones, set priorities, take frequent breaks, and don't neglect self-care. Pregnancy is a marathon, not a sprint. With patience and diligence, you can get across the finish line!

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.