Pregnancy in Women with Aortic Stenosis
DOI:
https://doi.org/10.3889/oamjms.2014.077Keywords:
Pregnancy, aortic stenosis, complications, asymptomatic, severeAbstract
OBJECTIVE: The aim of this study was to provide data about the course and outcome of pregnancy in the women with aortic stenosis (AS) with special attention to complications in pregnant with severe AS, which was asymptomatic prior to conception.
METHODS: Eleven pregnant women with different grades of AS were monitored in ambulatory and clinical conditions during pregnancy, childbirth and the post-partum period. The Apgar scores of the neonates born by mothers with AS were compared to those of neonates born by healthy mothers, using the variation statistical analysis.
RESULTS: In the group with severe AS, asymptomatic prior to conception, aggravation of the NYHA functional class (FC) with left ventricular heart failure was observed. Pregnancy, childbirth and post-partum period were normal in the group with moderate aortic stenosis and in those with ventricular defects, corrected prior to conception. The sums of the Apgar scores for the whole group did not differ from those for the neonates, born by healthy mothers.
CONCLUSION: The results suggest that there is a need of consensus for the complex of examinations, enabling diagnostic differentiation of pregnant women with severe AS requiring urgent defect correction and, the prognosis of pregnancy in women with asymptomatic severe AS.Downloads
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Longo, Fauci, Kasper, Hauser, Jameson, Loscalzo, Harrison`s Principles of Internal Medicine, 18th Edition, 2011.
Oakley C., Child A., Lung L. et al. Task Force on the management of cardiovascular diseases during pregnancy of the European Society of Cardiology – Expert Consensus document on management of cardiovascular diseases during pregnancy. Eur Heart J. 2003; 94:761-781.
Thorn S.A. Pregnancy in heart disease. Heart. 2004; 90:450-456. DOI: https://doi.org/10.1136/hrt.2003.027888
Elkayam U. and Gleicher N. Hemodynamics and cardiac function during normal pregnancy and the puerperium. In: Elkayam U, Gleicher N, editors. Cardiac problems in pregnancy: diagnosis and management of maternal and fetal disease. 2nd ed. New York: Alan R Liss, 1990. p.5-30.
Hameed A., Karaalp I. S., Tummala P. P. et al. The effect of valvular heart disease on maternal and fetal outcome of pregnancy. J Am Coll Cardiol. 2001; 37:893-899. DOI: https://doi.org/10.1016/S0735-1097(00)01198-0
Malhotra M., Sharma J.B., Tripathii R. et al. Maternal and fetal outcome in valvular heart disease. Int J Gynecol Obstet. 2004; 84:11-16. DOI: https://doi.org/10.1016/S0020-7292(03)00317-5
Bonow R.O., Carabello B.A., Kanu C., de Leon A.C. et al. ACC/ANA 2006 Guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology. Circulation. 2006; 114:e84-e231. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.177303
Vahanian A., Baumgartner H., Bax J. et al. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007; 28:230-268. DOI: https://doi.org/10.1093/eurheartj/ehm095
Paul Das, Helen Rimington and John Chambers. Exercise testing to stratify risk in aortic stenosis. Eur Heart J. 2005; 26:1309-1313. DOI: https://doi.org/10.1093/eurheartj/ehi250
ESC guidelines on the management of cardiovascular diseases during pregnancy. Eur Heart J. 2011; 32:3147-3197.
Helena J. Heuvelman, MD, MSa, Bardia Arabkhani, MSc, Jerome M. J. Cornette, MD et al.Pregnancy Outcomes in Women With Aortic Valve Substitutes. Am J Cardiol. 2013; 111; 382-387 DOI: https://doi.org/10.1016/j.amjcard.2012.09.035
Braunwald E. Valvular heart disease. In: Braunwald E, editor. Heart Disease. 5th ed. Philadelphia: Saunders, 1997:1007–76.
Widerhorn J, Widerhorn AL, Rahimtoola SH, Elkayam U. WPW syndrome during pregnancy: increased incidence of supraventricular arrhythmias. Am Heart J. 1992;123:796–8. DOI: https://doi.org/10.1016/0002-8703(92)90526-2
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