Clinical and echocardiographic assessment of pregnant women with valvular heart diseases--maternal and fetal outcome.
The study aimed to compare the outcome of pregnancy in women with valvular heart diseases.


METHODS
Two hundred and fifty-nine pregnant women with cardiac diseases, aged 18-42, were observed. Group I-158 patients with mitral valve disease: 30 patients with mitral stenosis; 44 patients with mitral regurgitation, 33 patients with combined mitral valve disease, 51 patients with mitral valve prolapse; Group II-54 patients with aortic valve disease: 32 patients with aortic stenosis, 22 with aortic regurgitation; Group III-47 patients after valve replacement (36 mechanical; 11 homograft valves). Medical history and physical examination, NYHA class assessment, ECG, and echocardiography were performed during consecutive trimesters of pregnancy and after delivery.


RESULTS
Clinical deterioration was observed in 38 patients-in 25 women of Group I, 6 women of Group II, and 7 women of Group III. Newborns outcome : 250 healthy (10 prematures, 12 with intrauterine growth retardation), 6 aborted, 2 stillbirths, 1 neonatal death. Method of delivery : 200 vaginally, 53 cesarean sections.


CONCLUSIONS
(1). Pregnants with critical mitral valve stenosis form a high-risk group of life-threatening complications. (2) In women with severe aortic stenosis, pregnancy could lead to sudden clinical status deterioration. (3) Cardiac complications can be expected in patients with left ventricular enlargement and its depressed function. (4) Key factors influencing successful course of pregnancy and labour in patients with prosthetic valves: adequate left ventricular function, properly functioning valves, and effective anticoagulation.
Department of Cardiovascular Diseases, Institute of Cardiology, Jagiellonian University, School of Medicine, Ul. Pradnicka 80, 31-202 Cracow, Poland. alesniak@szpitaljp2.krakow.pl
Agata
A
Leśniak-Sobelga
Wieslawa
W
Tracz
Magdalena
M
KostKiewicz
Piotr
P
Podolec
Mieczystaw
M
Pasowicz
D000293:Adolescent; D000328:Adult; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007231:Infant, Newborn; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000175:diagnosis / Q000601:surgery; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011256:Pregnancy Outcome; D016896:Treatment Outcome