Infective Endocarditis in Pregnancy: Unveiling the Challenges, Outcomes, and Strategies for Management

Abstract

Infective endocarditis (IE) is a serious and potentially fatal infection affecting cardiac endothelium and valves, with a significant increase in its incidence. This comprehensive review aims to discuss the challenges of diagnosing and managing IE during pregnancy, highlighting the absence of research and randomized clinical trials. Despite its low occurrence, IE in pregnancy is associated with significant maternal and fetal mortality rates, often complicated by prematurity. This review covers the physiological changes during pregnancy that can mask the symptoms of IE and the epidemiological shift in risk factors, including the rise in opioid addiction and the use of cardiac devices. It also sheds light on the specific microorganisms responsible for most IE cases. This paper involved a detailed search of PubMed databases, focusing on studies related to IE in pregnant patients, including those addressing fetal and maternal outcomes. It highlights the diagnostic challenges posed by the physiological changes in pregnancy, the impact of IE on maternal and fetal health, and the lack of specific treatment guidelines for pregnant women. We stress on the importance of a multidisciplinary approach to care, aiming to enhance early diagnosis, effective patient care strategies, and overall outcomes for this vulnerable population. Finally, our findings underscore the need for more research and the development of evidence-based guidelines to improve the management of IE in pregnancy.