This week we focus on a congenital heart disease patient's battle for a child.

Nicky Vanner is a loving mother to a beautiful baby boy.

But this happy shot of mother and child hides the terrible physical struggles Nicky went through to have Felix.

Nicky, a London nurse, was born with congenital heart disease (CHD), but was determined to have a baby.

Doctors at the Royal Brompton, where she receives treatment, agreed that she was fit enough to give birth, but said she would need constant checking throughout the pregnancy.

Pregnant

Nicky quickly got pregnant and for the first few months all went well.

But then a 13 week scan revealed a serious deterioration of her heart.

I was given the choice of having a termination Nicky Vanner

"We had the hoo haa about whether to terminate or whether to have the baby.

"It was horrendous. We had the 12 weeks mark out of the way (the stage before which most miscarriages happen) and then this happened just a week later.

"I was given the choice of having a termination and then having a heart operation; to continue with the pregnancy and then have the operation or for them to try and operate while I was pregnant."

Nicky wanted to persue the second option. Medics knew it was a risk, but after careful monitoring they agreed it would be reasonable to carry on.

Thanks to the expert care she received at the Brompton, her son was born safe and well last June.

"I was very lucky.

"Felix is fantastic and he has no heart problems."

Risks

Nicky admitted though that she would love another baby, but said she thinks it is too risky.

"It is really hard. I would love to have another baby, but it would be risky and Guy, my husband, does not want to discuss it."

Nicky is now waiting for her operation, but admits her condition is worsening.

"The doctors seem to think things are getting worse, but I feel absolutely fine. I have always had this condition and I still manage to play tennis and ski," she said.

Professor Philip Steer, professor of obstetrics at Imperial College, London, who monitored Nicky through her pregnancy said women like her needed careful watching during pregnancy.

He said too many women with heart problems were escaping through the net.

"I saw somebody yesterday who is fairly well on in her pregnancy and had been treated at a district hospital where the risks had not been appreciated."

He said that patients like this needed specialist care.

"The biggest problem is that the seriousness of heart disease in pregnancy is not often recognised."

Mortality

Professor Steer explained that patients like Nicky had a higher mortality rate during pregnancy because of the extra demands that birth puts on their body.

"These are not minor risks by any means, these are very courageous women who are doing their best to live normal lives and to be normal mums.

"But for instance we have one woman coming in for delivery who has a 30% chance that she will not wake up after her operation to give birth."

Professor Steer said that during the pregnancy he would keep a close eye on the woman's blood pressure, check her pulse rate and heart rhythm and listen to the heart murmur to check she did not have any infections, which could prove fatal.

"If they get an infection it can turn them from someone who is coping well to someone who is on death's door. And it can come out of the blue."

Professor Steer said it was important to talk through with patients their life expectancy so that they knew what impact this would have on any future children.

He said that this was a difficult and sensitive area, but one that needed broaching.

"They do need to think about what will happen to the children if they become ill or disabled.

"This clearly has an impact on the children and is something they need to think about.