Prise en charge du rétrécissement mitral durant la grossesse au centre hospitalo-universitaire d’Oran : à propos de 83 cas

Abstract

IntroductionThe management of pregnancy in patients with mitral valve stenosis disease continues to pose a challenge to the clinician. ObjectiveThe aim of study was to evaluate the association between mitral valve stenosis and maternal and fetal out come. Materiel and methodEighty-three pregnant women with mitral valve disease, followed-up from 2009 to 2012, were prospectively evaluated medical history, NYHA class assessment, ECG and echocardiography were performed during pregnancy and after delivery. ResultsWomen with mitral stenosis had significantly clinical higher incidence of complications deterioration of clinical status was observed (44.57%, P=0.0001) congestive heart failure had observed (27.71%, P=0.0001), hospitalization (33.73%, P=0.0001), need of cardiac medications (53.75%, P=0.009), arrhythmias (16%, P<0.05), New born outcome, mitral stenosis had an effect on fetal outcome. We had increasing preterm, delivery (17.50%, P=0.018), hypotrophy (20.48%, P=0.001), intra-uterine growth retardation (12.04%, P=0.011) new born hospitalizations (13.25%, P=0.03) Increased maternal morbidity and unfavorable fetal outcome was seen mostly in patients with moderate and severe mitral stenosis. ConclusionPregnant with critical mitral stenosis form a high-risk groups of life-threatening complications. There is need for close maternal follow-up and fetal surveillance and repair of mitral stenosis should be performed before pregnancy.