Clinical treatment of infectious endocarditis with vegetation in pregnant women and gestational outcomes

Abstract

Infectious endocarditis is a rare condition in pregnant women. Study clinical treatment of infectious endocarditis with vegetation in pregnant women. Nine cases of pregnant women diagnosed as infectious endocarditis with vegetation from January 2014 to December 2020 were included in a retrospective analysis. Clinical treatments including general, anti-infective treatments, cardiac surgery, termination of pregnancy, were carried out through collaboration between the relevant services. Clinical traits, treatment regimens, maternal and neonatal outcomes of the 9 cases were analyzed. The age was 25 to 36 years. The onset gestational age was 19 to 36 weeks. Clinical symptoms: fever, cough and progressive anemia were the main symptoms. The heart murmur was audible and splenomegaly was affected during the physical examination. Hemocultures were positive. Types of heart disease: 7 cases of congenital heart disease included 2 cases of aortic insufficiency, 1 of mitral insufficiency, 1 of arterial canal persistence, 1 of right ventricular stenosis and 2 of interventricular communication. Rheumatic heart disease included 2 cases of mitral stenosis. General treatment included oxygen intake, cardiac strengthening and diuretic therapy. Nine cases of pregnant women all underwent surgical treatment of heart disease and removal of endocardic vegetation. Caesarean sections were performed for 2 cases in the second trimester and 7 in the last trimester. Cardiac surgery and cesarean section were operated on in 6 cases at the same time over 22 to 34 weeks of pregnancy. Cardiac surgeries were operated on in 2 cases after cesarean section. While cardiac surgery was operated on before caesarean section in another case. Maternal and neonatal outcomes: 7 cases of pregnant women were successfully saved. The risk is extremely high from pregnancy with infectious endocarditis.But there is still a way to save maternal and neonatal life.