Fetal and obstetrical impact of percutaneous balloon mitral commissurotomy during pregnancy.
Since 1984 percutaneous mitral balloon commissurotomy (PMC) has replaced closed mitral commissurotomy in most of its indications. However the application of this technique to pregnant women had raised considerable concern essentially because of the risk of fetal distress and irradiation. Of 1,017 PMC performed between March 1986 and December 1992, 11 were carried out during pregnancy. At the time of the procedure gestational time ranged from 24 to 34 weeks of amenorrhea. PMC resulted in immediate hemodynamic improvement and there were no major maternal complications. Maternal abdominal radiation was always less than 0.2 mSv. Fetal heart rate was monitored during the procedure and showed only minor abnormalities. The outcomes of these 11 pregnancies were: 4 vaginal deliveries after 37 weeks, 5 cesarean sections after 37 weeks and 1 at 29 weeks. All newborn children were normotrophic and without malformation.
Sananes
S
S
Clinique universitaire Guy-le-Lorier, Hôpital Tenon, Paris, France.
Iung
B
B
Vahanian
A
A
Acar
J
J
Salat-Baroux
J
J
Uzan
S
S
D000328:Adult; D002404:Catheterization; D005260:Female; D005323:Fetal Monitoring; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006439:Hemodynamics; D006801:Humans; D008946:Mitral Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011256:Pregnancy Outcome; D011859:Radiography