Abstract
Objectives: The aim of the study was evaluate maternal and fetal outcomes of mitral stenosis at pregnant women. Methods: Forty-one pregnant woman with moderate and severe mitral stenosis were enrolled in the study. Predictor variables were the apgar score, new born weight and delivery week. Progression of NYHA functional class, thromboembolism, death, new onset atrial fibrillation was accepted as maternal event. Abortion, fetal or neonatal death, prematurity or low birth weight were accepted as fetal events. Results: In newborn babies, 10 were followed-up in intensive care. The mothers of these infants had higher LA diameters, their MVA’s were smaller and the pulmonary hypertension was higher.It was observed that the LA diameter and warfarin treatment were independent risk factors for the need for intensive care. The NYHA was primarily dependent from the LA diameter, followed by the MVA, mean difference in the pressure and the pulmonary artery pressure (PAP).The independent risk factors of the birth weight and the 1st min. and 5th min. Apgar scores, only the LA diameter was found as significant. Also, the independent risk factors of the gestational age at birth are the NYHA classification and the MVA. Warfarin treatment in the mother has also been observed as a risk factor for IUGR. Conclusion: These results reveal that especially patients with mitral stenosis should be closelymonitored throughout their pregnancy.
Highlights
A rarely observed heart condition, severe forms of rheumatic mitral stenosis (MS) may be life-threatening during pregnancy [1,2]
During the follow-up of patients having additional valve problem, there was no sign of problem obtained associated with mother and child
While 10 among our patients had atrial fibrillation (AF) at the beginning of the study, 5 more have developed paroxysmal AF in the course of the study. In these patients sinus rythm was provided by electrical cardioversion
Summary
A rarely observed heart condition, severe forms of rheumatic mitral stenosis (MS) may be life-threatening during pregnancy [1,2]. Previous studies have demonstrated that MS influences the fetal outcome and may lead to higher risks of preterm delivery, intrauterine growth retardation and reduced birth weight [5]. It may be wise to advise women with moderate or severe MS planning to get pregnant to undergo corrective treatment for the valvular disease before motherhood. Considering the risk profiles of the individual treatment modalities, the correct selection of the medication to be applied during pregnancy is of utmost importance both for the mother and the fetus. The aim of the present study is to assess the influence of MS on the maternal and fetal outcome of the pregnancy
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