Abstract
Background: Aortic stenosis (AS) is one of the degenerative heart lesions mainly resulting from congenital defects and rheumatic diseases. This study aimed to determine maternal and fetal outcomes in pregnant women with moderate and severe AS. Methods: The clinical data of 26 pregnant women with AS treated between 2007 and 2019 in Beijing Anzhen Hospital were collected and retrospectively analyzed. Results: AS was diagnosed before pregnancy or after pregnancy in 16 (61.5%) and 10 (38.5%) patients, respectively. Except the peak velocity and mean pressure gradient, no significant difference in baseline cardiac parameters between the patients with moderate AS and severe/very severe AS, such as AS locations, previous heart failure symptoms, and heart function was seen. Heart failure and arrhythmia were complicated in 14 (53.8%) and 6 (23.1%) pregnancies, respectively. The rate of Caesarean deliveries was 85.7% in the patients with severe/very severe AS and 58.3% in the patients with moderate AS. There was no neonatal asphyxia or neonatal death in the cohort. Conclusions: The results of our study indicate the pre-conceptional evaluation and counseling should be performed in women with AS and those with symptomatic and severe AS are recommend to take cardiac surgery as appropriate before pregnancy.
Highlights
Aortic stenosis (AS) is one of the degenerative heart lesions mainly resulting from congenital defects and rheumatic diseases
Because the risk of mother and fetus is low in women with mild AS [6], the present study focused on women with moderate and severe AS and found that most pregnancies were uncomplicated in pregnant women with AS, even in some with severe AS
It was noted that patients with severe/very severe AS have a higher rate of deterioration in the New York Heart Association (NYHA) status during pregnancy
Summary
Aortic stenosis (AS) is one of the degenerative heart lesions mainly resulting from congenital defects and rheumatic diseases. AS may be aggravated by the reduced stroke volume occurring with pregnancy, and results in increased maternal cardiovascular events and fetal complications [2,3,4]. Most previous studies focused on cardiac outcomes [2,3,4,7], with little information on maternal and fetal outcomes in patients with AS. This study aimed to determine maternal and fetal outcomes in pregnant women with moderate and severe AS. Conclusions: The results of our study indicate the pre-conceptional evaluation and counseling should be performed in women with AS and those with symptomatic and severe AS are recommend to take cardiac surgery as appropriate before pregnancy
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