title: Treatment of valvular heart disease during pregnancy for improving maternal and neonatal outcome.
abstract: BACKGROUND
  Valvular heart disease constitutes the majority of all causes of heart disease in pregnancy. In the presence of valvular heart disease, the necessary haemodynamic changes of pregnancy might cause heart failure, leading to severe maternal and fetal morbidity and even mortality. Treatment of valvular heart disease is indicated when patients experience a deterioration of symptoms and in case of a severe valvular lesion. Whether medical therapy or interventional therapy is the optimal treatment for both mother and child is unclear.
  
  
  OBJECTIVE
  To assess effectiveness and adverse effects of the different treatment modalities of valvular heart disease in pregnancy to improve maternal and neonatal outcomes.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2011), EMBASE (1980 to 23 March 2011) and the reference lists of background review articles.
  
  
  METHODS
  Randomised controlled trials, quasi-randomised controlled and cluster-randomised controlled trials comparing medical therapy with percutaneous or surgical intervention for the treatment of valvular heart disease in pregnancy.
  
  
  METHODS
  We identified no (randomised) controlled trials to assess the effectiveness and adverse effects of the treatment of valvular heart disease in pregnancy.
  
  
  RESULTS
  There were no randomised controlled trials, quasi-randomised controlled trials or cluster-randomised trials identified from the search strategy.
  
  
  CONCLUSIONS
  There is insufficient evidence to define the most effective treatment of valvular heart disease in pregnancy to improve maternal and neonatal outcomes.
authors.affiliation: Department of Gynaecology, Medical Centre Haaglanden, Lijnbaan 32, The Hague, Netherlands.
authors.forename: Dacia Dca
authors.initials: DD
authors.lastname: Henriquez
authors.forename: Jolien W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Robert Jm
authors.initials: RJ
authors.lastname: Klautz
authors.forename: Frans M
authors.initials: FM
authors.lastname: Helmerhorst
authors.forename: Christianne Jm
authors.initials: CJ
authors.lastname: de Groot
mesh_terms: D015331:Cohort Studies; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008946:Mitral Valve Stenosis / Q000601:surgery*; D011183:Postoperative Complications; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D011256:Pregnancy Outcome