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[Course of pregnancy and puerperium in women with mitral valve stenosis]
W S Avila1, M Grinberg, L F Cardoso
1Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP.
Purpose:
To study pregnancy, delivery, puerperium and the newborn in cases of mitral valve stenosis, asymptomatic at conception.
Method:
Sixty-two pregnant women, 30 with mitral valve stenosis (GE group) and 32 without cardiac disease (GN group) had their functional class, kind of delivery, anesthetic technique and newborn characteristics evaluated during gestation.
Results:
In GE group 16 (53.3%) patients changed from functional class (FC) I/II to FC III and 10 (33.3%) to FC IV. In GN group 18 (56.2%) changed from FC I to II during the gestation. Delivery was vaginal in 21 patients (70%); anesthetic technique was regional block in 17 (56.6%). These findings were not statistically different between (p > 0.1) the groups. Premature (20.0%) and small babies for gestational age (36.7%) were higher (p > 0.001) in GE group. There were no cases of maternal death.
Conclusion:
The majority of GE women who started pregnancy in FC I/II changed to FC III/IV during gestation. Probably adequate medical treatment and valvoplasty in one case allowed fetal viability; but we had higher incidence of pre-term and small for gestation age babies in the GE group.