title: Surgery for rheumatic valve disease in pregnancy: what about the newborn?
abstract: BACKGROUND
  Valvular heart disease constitutes the majority of all causes of cardiac disease in pregnancy. The significant physiological haemodynamic changes of pregnancy may cause serious cardiac problems leading to severe maternal and foetal morbidity and mortality. In this study, we evaluate the effect of maternal rheumatic valvular disease requiring definitive operation concurrent with caesarian delivery on maternal and foetal outcome.
  
  
  METHODS
  Between 2003 and 2010, a total of nine pregnant women and nine live births were examined. Immediately after caesarean section, the newborns were examined by the neonatologist and transferred to the neonatal intensive care unit. All the mothers were followed routinely with clinical and echocardiographic examinations.
  
  
  RESULTS
  The age at the time of delivery ranged between 21 and 36 years (median 31 years). Postoperative period of mothers was uneventful and mean hospital stay was 7.56±3.97 days. Birth weight for the newborns was ranged between 1370 and 2900g. Six of the newborns were premature (≤37 weeks). Four newborns were small for gestational age (SGA). There was no mortality in newborns. Hospital stay for the newborns ranged between four and 54 days.
  
  
  CONCLUSIONS
  Careful follow-up of pregnancies with valvular heart diseases and determining the optimal time of cardiac intervention are the essential issues. We suggest that careful follow-up of both mother and foetus until at least the 28th gestational week, following which combined caesarian section and cardiac surgery can be performed.
authors.affiliation: Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Cemal Levent
authors.initials: CL
authors.lastname: Birincioglu
authors.affiliation: Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey. Electronic address: utkuunal@gmail.com.
authors.forename: Ertekin Utku
authors.initials: EU
authors.lastname: Unal
authors.affiliation: Neonatal Intensive Care Unit, Mersin Maternal and Child Health Hospital, Mersin, Turkey.
authors.forename: Istemi Han
authors.initials: IH
authors.lastname: Celik
authors.affiliation: Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Anil
authors.initials: A
authors.lastname: Ozen
authors.affiliation: Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Sercan
authors.initials: S
authors.lastname: Tak
authors.affiliation: Department of Cardiovascular Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Aksoyek
authors.affiliation: Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Erdeve
authors.affiliation: Neonatal Intensive Care Unit, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey; Department of Pediatrics, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Dilmen
mesh_terms: D006348:Cardiac Surgical Procedures; D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D050498:Live Birth; D008297:Male; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000150:complications / Q000601:surgery*
keywords: Cardiac surgery; Newborn; Outcome; Pregnancy; Valvular heart disease