Pregnancy Outcome and Mitral Valve Prolapse

Abstract

Mitral valve prolapse (MVP) comprises a large proportion of obstetric cardiac problems and has a general prevalence of 4%. We examined the obstetric outcome of patients with MVP delivered between 1988—1991 at the National University Hospital, Singapore. During this interval, deliveries totalled 16,755 of which 85 (0.51%) had maternal cardiac disease. Of these, 28 (32.9%) had echocardiographic evidence of non‐myxomatous MVP. Ten patients (37.5%) had demonstrable mitral regurgitation and 4 (14.3%) had benign ventricular ectopics. All patients remained well throughout pregnancy. Gestation at delivery and use of analgesia did not differ significantly from non‐cardiac patients. However, the labour induction rate was twice the department average at 17.9%. Twenty‐four (85.7%) patients achieved vaginal delivery and 4 (14.3%) patients were delivered abdominally. All babies were liveborn. Eight patients (28.6%) did not receive antibiotic prophylaxis during labour and postpartum period and remained afebrile. The role of antibiotics in this category of patients is discussed. Patients with MVP without myxomatous valve changes may expect excellent pregnancy outcome.

Repetitive out of hospital cardiac arrests following pregnancy: a case report of an unfortunate presentation of mitral annular disjunction

“…Life-threatening VT and VF are very rare during pregnancy or after delivery, but are associated with elevated odds for mortality (OR 40.89, 95% CI 26.08–64.1; P < 0.0001) and increased frequencies of maternal and foetal complications. 2 , 9 Arrhythmia has been reported as a complication of mitral valve prolapse during pregnancy, 10 but as far as we know the relation between MAD and occurrence of arrhythmia during pregnancy has not yet been explored. Perhaps, the so-called ‘mitral valve prolapse syndrome’, which is mentioned in the older literature as being associated with sudden death, was in fact MAD, only not recognized as such.…”

Connective tissue dysplasia: new horizons of the problem

“…N. Jana описывает случаи самопроизвольных абортов, преждевременных родов и внутриутробной гибели плода 23 , а Y.T. Chia указывает на повышенную потребность в стимуляции родовой деятельности 24 .…”

Mitral valve prolapse in pregnancy

“…In contrast, patients with secondary MVP have thin leaflets, which prolapse slightly into the left atrium during systole as a result of mismatch of the anatomical relationship between the mitral valve apparatus and left ventricle. Hence, secondary MVP may be seen in secundum atrial septal defects, infective endocarditis, rheumatic mitral stenosis and calcified mitral annulus [ 4 ] . The reason of the mucopolysaccharide accumulation predilection in the mitral valve remains uncertain.…”

“…Nevertheless, it is believed that MVP is a result of progressive myxomatous valve changes and it may bring about chordal rupture in some patients [ 6 ] . The progression of MVP into severe MR usually occur after the age of 50 years [ 3 ] ; whereas younger patients may have good exercise tolerance, and would not show any circulatory deterioration [ 4 ] .…”

“…Women with MVP in the absence of other cardiovascular disorders may tolerate pregnancy well and do not develop remarkable cardiac complications. Although rare, more serious complications of MVP, such as arrhythmia, infective endocarditis and cerebral ischemic events, have been reported during pregnancy [ 4 ] . Debates still remain in the management of MVP in the pregnant patients.…”