title: Bicuspid aortic valve in pregnancy.
abstract: OBJECTIVE
  The outcomes in pregnant patients with bicuspid aortic valves (BAVs) are rarely reported, despite the potentially critical nature of the condition. The aim of this study is to present the clinical complications of BAV in pregnancy.
  
  
  METHODS
  A MEDLINE database search and a Google internet search were conducted to find literature on BAV in pregnancy published between 1980 and 2012.
  
  
  RESULTS
  BAV in pregnancy can lead to critical cardiovascular events including aortic dissection, aortic valve disorders, and infective endocarditis; some of these complications may lead to poor maternal outcomes or fetal demise. No differences were noted in either maternal or fetal mortality between syndromic and nonsyndromic pregnant patients with BAV (maternal: 50% vs. 28.6%; p = 0.4959; fetal: 25% vs. 0%; p = 0.1987). The peak and mean pressure gradients across the aortic valve increased significantly with advancing gestational trimester; a remarkable decrease in peak pressure gradients was seen postpartum. The calculated aortic valve area showed a significant decrease in the third trimester compared with the prepregnancy value, as well as a considerable postpartum decrease.
  
  
  CONCLUSIONS
  Syndromic and nonsyndromic BAVs may have similar importance for maternal and fetal mortality. Aortic valve stenosis may become more severe with advancing pregnancy, with attenuation after delivery. Patients may require surgical intervention for the complications of BAV during pregnancy.
authors.affiliation: Department of Cardiothoracic Surgery, The First Hospital of Putian, Teaching Hospital, Fujian Medical University, Putian, Fujian Province, People's Republic of China. Electronic address: shi_min_yuan@yahoo.com.
authors.forename: Shi-Min
authors.initials: SM
authors.lastname: Yuan
mesh_terms: D000784:Aortic Dissection / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D001014:Aortic Aneurysm / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D018450:Disease Progression; D004696:Endocarditis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery
keywords: aortic disorder; bicuspid aortic valve; cardiovascular pregnancy complication; cardiovascular surgical procedure; pregnancy trimester