Valvular disease in pregnancy

The hemodynamics of pregnancy make this a time of great risk for the cardiac patient. RHD is still the most commonly seen lesion in women of childbearing age. When the mitral valve becomes stenotic, it severely limits flow into the left ventricle, resulting in a buildup of pressure in the left atrium and possibly the pulmonary artery. These patients are at risk for pulmonary edema and a decrease in cardiac output. Intrapartum care must focus on meticulous fluid management and alleviation of pain and anxiety to avoid the tachycardiac effect.