Abstract
Background & Objectives : We report 17 years outcome of subsequent pregnancies of women with severe Mitral Stenosis (MS) who underwent Mitral Balloon Valvuloplasty (MBV) during pregnancy and the follow up of the children born of such pregnancies. Methods: Twenty three pregnant patients suffering from severe MS (NYHA-New York Heart Association class III/IV) who underwent MBV by Inoue balloon catheter technique during second trimester were enrolled. The study was performed between January 1992 and December 2008 at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, during which time, details about the obstetric outcome and childhood development were recorded. Mean follow up period was 10± 5.5 years (range 1-17 years). Results: MBV was successful in all patients with improvement in their NYHA class to I/II. All patients were followed until term and had uneventful course after MBV. Twenty two (95.6%) patients delivered 23 babies including a twin birth. These children exhibited normal growth and development according to their age. Nineteen patients had further pregnancies and gave birth to 38 live & healthy babies with one still birth and no unfavorable maternal outcome. Of these, 97.4% were singleton pregnancies while 2.6% were twin pregnancies. Spontaneous abortions were recorded in 21.5% and there was one still birth (2.5%) and one ectopic pregnancy (2.5%). Conclusion : Mitral Balloon Valvuloplasty is a safe and useful procedure during pregnancy, with no short or long term adverse affects on the mothers and their obstetric future. The children born of subsequent pregnancies exhibited normal physical and mental development.
Highlights
Rheumatic Mitral Stenosis (MS) is the commonest cardiac valvular lesion in pregnancy
All patients were in the second trimester of their pregnancy and were symptomatic with NYHA class III/IV with mitral valve area (MVA)
Immediate outcome: MBV was successful in all patients with significant improvement in their NYHA class to I/II
Summary
Rheumatic MS is the commonest cardiac valvular lesion in pregnancy. MS can cause significant maternal as well as fetal mortality and morbidity. Several reports of its immediate effects on mothers and outcome of these pregnancies have shown a favorable result.[4,5,6] Few studies have reported long term outcome of pregnant mothers after MBV with favorable fetal and maternal outcome.[7,8,9,10] We report a long term obstetrical outcome of such women and the effects of MBV on the development of children born of subsequent pregnancies. We report 17 years outcome of subsequent pregnancies of women with severe Mitral Stenosis (MS) who underwent Mitral Balloon Valvuloplasty(MBV) during pregnancy and the follow up of the children born of such pregnancies. Twenty two (95.6%) patients delivered 23 babies including a twin birth These children exhibited normal growth and development according to their age. The children born of subsequent pregnancies exhibited normal physical and mental development
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