Treatment of valvular heart disease during pregnancy for improving maternal and neonatal outcome

Henriquez, Dacia D. C. A.; Roos‐Hesselink, Jolien W.; Schalij, Martin J.; Klautz, Robert J.M.; Helmerhorst, Frans M.; Groot, Christianne JM de

doi:10.1002/14651858.cd008128

Cited by 5 publications

(8 citation statements)

References 14 publications

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“…Our results indicate that RHD in pregnancy is associated with poorer perinatal outcomes as has been previously reported . There was a high risk of prematurity with 21% of neonates born preterm compared with 9% overall in Australia and 14% for babies born to Aboriginal mothers .…”

Section: Discussionsupporting

confidence: 79%

The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high‐income setting: a prospective cohort study

Sullivan

Vaughan

et al. 2019

BJOG

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Objective To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). Design Prospective population‐based study. Setting Hospital‐based maternity units throughout A&NZ. Population Pregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014. Methods We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De‐identified antenatal, perinatal and postnatal data were collected and analysed. Main outcome measures Prevalence of RHD in pregnancy. Perinatal morbidity and mortality. Results There were 311 pregnancies associated with women with RHD (4.3/10 000 women giving birth, 95% CI 3.9–4.8). In Australia, 78% were Aboriginal or Torres Strait Islander (60.4/10 000, 95% CI 50.7–70.0), while in New Zealand 90% were Māori or Pasifika (27.2/10 000, 95% CI 22.0–32.3). One woman (0.3%) died and one in ten was admitted to coronary or intensive care units postpartum. There were 314 births with seven stillbirths (22.3/1000 births) and two neonatal deaths (6.5/1000 births). Sixty‐six (21%) live‐born babies were preterm and one in three was admitted to neonatal intensive care or special care units. Conclusion Rheumatic heart disease in pregnancy persists in disadvantaged First Nations populations in A&NZ. It is associated with significant cardiac and perinatal morbidity. Preconception planning and counselling and RHD screening in at‐risk pregnant women are essential for good maternal and baby outcomes. Tweetable abstract Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.

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Section: Discussionsupporting

confidence: 79%

The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high‐income setting: a prospective cohort study

Sullivan

Vaughan

et al. 2019

BJOG

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“…Treatment of a specific valvular lesion during pregnancy may be required in the presence of heart failure, arrhythmia, or hemodynamic deterioration, in order to prevent significant maternal or fetal morbidity or mortality. However, the optimal treatment pathway to improve maternal and fetal outcomes, whether medical or interventional, remains unclear . A brief review of the medical therapies used during pregnancy for heart failure symptoms can be found in Table .…”

Section: Specific Valve Lesions and Therapiesmentioning

confidence: 99%

Pregnancy Complicated by Valvular Heart Disease: An Update

Nanna

Stergiopoulos

2014

JAHA

108

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“…Invasive procedures like PTMC should be considered for pregnant women with acute presentation as in our first case or with significant functional deterioration or refractory pulmonary oedema despite optimal medical management, provided the valve is suitable for the procedure. [12][13][14] In our second case, elective PTMC was indicated as she would likely to decompensate at some point in the third trimester of pregnancy or during labour given her such marked limitation to her exercise tolerance. This was more likely as she developed AF.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous mitral commisurotomy during pregnancy – A report of two cases performed in a United Kingdom tertiary centre and a review of the literature

et al. 2015

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We report two cases of severe mitral stenosis where percutaneous mitral commisurotomy was performed within pregnancy. The first case involves an emergency procedure for a new diagnosis of severe mitral stenosis in a woman presenting with pulmonary oedema at 27 weeks' gestation. The second case is of a woman known to have mitral stenosis who underwent a semi-elective procedure for deterioration in symptoms. This procedure is not commonly performed in the United Kingdom because of low incidence of rheumatic heart disease. In addition, percutaneous mitral commisurotomy during pregnancy is rarely performed in the United Kingdom because of the improved healthcare system where majority of the women with moderate to severe mitral stenosis (even asymptomatic) will undergo planned interventions (percutaneous mitral commisurotomy or mitral valve surgery) before contemplating pregnancy. These cases highlight both the acute and chronic presentations of mitral stenosis and the impact pregnancy has on this condition. In addition, these cases show the importance of retaining skills in performing percutaneous mitral commisurotomy within our United Kingdom cardiologists.

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Treatment of valvular heart disease during pregnancy for improving maternal and neonatal outcome

Cited by 5 publications

References 14 publications

The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high‐income setting: a prospective cohort study

The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high‐income setting: a prospective cohort study

Pregnancy Complicated by Valvular Heart Disease: An Update

Percutaneous mitral commisurotomy during pregnancy – A report of two cases performed in a United Kingdom tertiary centre and a review of the literature

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