title: Valvular heart disease in pregnancy.
abstract: In women with valvular heart disease, pregnancy-associated cardiovascular changes can contribute to maternal, foetal and neonatal complications. Ideally, a woman with valvular heart disease should receive preconception assessment and counselling from a cardiologist with expertise in pregnancy. For women with moderate- and high-risk valve lesions, appropriate risk stratification and management during pregnancy will optimise outcomes. Pregnancy in women with high-risk lesions, such as severe aortic stenosis, severe mitral stenosis and those with mechanical valves, requires careful planning and coordination of antenatal care by a multidisciplinary team. The purpose of this overview is to describe the expected haemodynamic changes in pregnancy, review pregnancy risks for women with valvular heart disease and discuss strategies for management.
authors.affiliation: University of Alberta, Mazankowski Heart Institute, Division of Cardiology, University of Alberta Hospital, Edmonton, Canada.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Windram
authors.affiliation: University of Toronto Pregancy and Heart Disease Program, Division of Cardiology, Mount Sinai Hospital, University Health Network and Women's College Hospital, Toronto, Canada.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Colman
authors.affiliation: University of Toronto Pregancy and Heart Disease Program, Division of Cardiology, Mount Sinai Hospital, University Health Network and Women's College Hospital, Toronto, Canada.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Wald
authors.affiliation: University of Toronto Pregancy and Heart Disease Program, Division of Cardiology, Mount Sinai Hospital, University Health Network and Women's College Hospital, Toronto, Canada.
authors.forename: Jacob A
authors.initials: JA
authors.lastname: Udell
authors.affiliation: University of Toronto Pregancy and Heart Disease Program, Division of Cardiology, Mount Sinai Hospital, University Health Network and Women's College Hospital, Toronto, Canada; University of Western Ontario, Division of Cardiology, University Hospital, London, Canada.
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Siu
authors.affiliation: University of Toronto Pregancy and Heart Disease Program, Division of Cardiology, Mount Sinai Hospital, University Health Network and Women's College Hospital, Toronto, Canada. Electronic address: candice.silversides@uhn.ca.
authors.forename: Candice K
authors.initials: CK
authors.lastname: Silversides
mesh_terms: D005260:Female; D006349:Heart Valve Diseases / Q000503:physiopathology* / Q000628:therapy*; D006350:Heart Valve Prosthesis; D006801:Humans; D016742:Preconception Care; D011247:Pregnancy / Q000502:physiology; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology* / Q000628:therapy*; D011295:Prenatal Care
keywords: aortic stenosis; mechanical valve; mitral stenosis; pregnancy; prosthetic valve; valvular heart disease