Effect of pulmonary stenosis on pregnancy outcomes--a case-control study

Pulmonary stenosis (PS) accounts for 10% to 12% of congenital heart disease in adults, and the probability of survival to child bearing age is high. The impact of PS on pregnancy has not been extensively studied in the recent era.

We evaluate the effect of isolated PS on maternal and fetal outcomes in a case-control study of 17 cases with PS in pregnancy from 1995 to 2006. The control group was matched by age, ethnicity, obstetrical history, and year of delivery. Patients with PS were assessed for maternal New York Heart Association (NYHA) functional class and other maternal complications at baseline and during pregnancy; and the 2 groups were compared for fetal and neonatal outcomes including birth weight, gestational age at delivery, Apgar scores, and placental weight.

A total of 11 patients were in NYHA functional class I and 6 in class II at the time of presentation. All patients remained stable during pregnancy except for two. One of them deteriorated from NYHA functional class I to II, and the other from class II transiently to class III. There were no other maternal complications. In addition, there were no statistically significant differences in fetal/neonatal outcomes between patients and their controls and between patients with mild and severe PS.

In contrast to mitral and aortic stenosis, PS does not adversely impact maternal or fetal outcomes of pregnancy.