Beta-adrenergic receptor blockade in the management of pregnant women with mitral stenosis.
Twenty-five pregnant women with symptomatic mitral valve stenosis (mean valve area, 1.1 +/- 0.25 cm2) were managed by initiation or modification of beta-adrenergic receptor blockade with the use of either propranolol or atenolol. Significant improvement of symptoms occurred in 23 patients (92%) (p less than 0.01); the mean maternal heart rate was reduced significantly from 86 +/- 4 to 78 +/- 5 beats/min (p less than 0.0001). The overall fetal heart rate ranged between 130 to 150 beats/min during treatment. Only two patients required urgent closed mitral valvotomy, after pulmonary edema developed as a result of poor compliance to beta-blockade. All patients were safely delivered of infants at term. Fetal heart rates ranged between 120 to 140 beats/min at delivery. There was no maternal or fetal death. Pregnant woman with symptomatic mitral valve stenosis can be safely managed with beta-blockade, giving significant reduction in the incidence of pulmonary edema with no unwanted neonatal side effect.
al Kasab
S M
SM
Riyadh Cardiac Centre, Armed Forces Hospital, Saudia Arabia.
Sabag
T
T
al Zaibag
M
M
Awaad
M
M
al Bitar
I
I
Halim
M A
MA
Abdullah
M A
MA
Shahed
M
M
Rajendran
V
V
Sawyer
W
W
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D001724:Birth Weight; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D008946:Mitral Valve Stenosis / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D012720:Severity of Illness Index
D000319:Adrenergic beta-Antagonists