title: Clinical and echocardiographic follow-up in pregnant patients with valvular heart disease.
abstract: OBJECTIVE
  Pregnancy associated cardiovascular changes may result in a significant hemodynamic burden and can lead to morbidity and even mortality in women with cardiac disease. The present study aimed to evaluate clinical and echocardiographic follow-up in pregnant patients with valvular heart disease (VHD).
  
  
  METHODS
  The medical records of pregnant patients diagnosed with VHD from January 2004 to January 2011 were screened. Demographic characteristics including history of cardiac intervention performed during pregnancy, pulmonary edema, and maternal and fetal mortality, and cesarean section (C/S) history were collected from the hospital database and clinical records of the cardiology and obstetrics departments. The echocardiographic examination was carried out at presentation, 3rd trimester, and 1 month after delivery. The outcomes evaluated were cardiac intervention, pulmonary edema, and both fetal and maternal mortality during pregnancy and C/S.
  
  
  RESULTS
  We evaluated the outcomes of 884 pregnant patients with VHD. Adverse clinical outcomes including death, pulmonary edema, and valvular interventions were frequent among patients with severe VHD, whereas no adverse clinical outcome was observed in patients with mild-moderate VHD (n=49, 5.5% vs. n=0, 0%, p<0.001). In patients with severe VHD, clinical outcomes were frequent among patients with valve stenosis, but lower among patients with regurgitation [death 4 (0.45%) vs. 0 (0%); pulmonary edema (15 (1.7%) vs. 13 (1.5%); valvular intervention 11 (1.2%) vs. 6 (0.7%); respectively).
  
  
  CONCLUSIONS
  Valvular heart disease is associated with fetal/maternal morbidity and mortality. Pregnant with severe VHD constitute a high-risk group in which life-threatening complications are likely to occur in the course of pregnancy.
authors.affiliation: Department of Cardiology, Yüzüncü Yıl University, Faculty of Medicine, Van, Turkey. hasanaliq80@yahoo.com.
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Gümrükçüoğlu
authors.forename: Ayşe
authors.initials: A
authors.lastname: Güler
authors.forename: Dolunay
authors.initials: D
authors.lastname: Odabaşı
authors.forename: Hakkı
authors.initials: H
authors.lastname: Şimşek
authors.forename: Musa
authors.initials: M
authors.lastname: Şahin
authors.forename: Serkan
authors.initials: S
authors.lastname: Akdağ
authors.forename: Hekim
authors.initials: H
authors.lastname: Karapınar
authors.forename: Aytaç
authors.initials: A
authors.lastname: Akyol
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Güneş
authors.forename: Mustafa
authors.initials: M
authors.lastname: Tuncer
mesh_terms: D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases; D006349:Heart Valve Diseases / Q000175:diagnosis; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular