title: Valve disease in pregnancy.
abstract: Maternal cardiac disease is a major cause of non-obstetric morbidity and accounts for 10-25% of maternal mortality. Valvular heart disease may result from congenital abnormalities or acquired lesions, some of which may involve more than one valve. Maternal and fetal risks in pregnant patients with valve disease vary according to the type and severity of the valve lesion along with resulting abnormalities of functional capacity, left ventricular function, and pulmonary artery pressure. Certain high-risk conditions are considered contraindications to pregnancy, while others may be successfully managed with observation, medications, and, in refractory cases, surgical intervention. Communication between the patient׳s obstetrician, maternal-fetal medicine specialist, obstetrical anesthesiologist, and cardiologist is critical in managing a pregnancy with underlying maternal cardiac disease. The management of the various types of valve diseases in pregnancy will be reviewed here, along with a discussion of related complications including mechanical prosthetic valves and infective endocarditis.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, 622 W. 168th St, PH-16, New York, NY 10032.. Electronic address: cara.pessel@gmail.com.
authors.forename: Cara
authors.initials: C
authors.lastname: Pessel
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, 622 W. 168th St, PH-16, New York, NY 10032.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Bonanno
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002300:Cardiac Care Facilities / Q000458:organization & administration*; D003376:Counseling; D036861:Delivery, Obstetric / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008991:Monitoring, Physiologic / Q000379:methods; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology / Q000628:therapy*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011379:Prognosis
keywords: Aortic; Cardiac disease; Mitral; Pregnancy; Regurgitation; Stenosis; Valve