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Postcaesarean open-heart surgery for Streptococcus sanguinis infective endocarditis
Kiattisak Kongwattanakul1, Sirirat Tribuddharat, Sompop Prathanee
1Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
BMJ Case Reports
|November 16, 2013
Summary
This case study highlights the successful management of Streptococcus sanguinis infective endocarditis in a 33-week pregnant patient. A strategic delivery and mitral valve repair timeline ensured a positive outcome for both mother and child.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Infectious Diseases
Background:
- A 29-year-old woman, 33 weeks pregnant, presented with Streptococcus sanguinis infective endocarditis.
- The patient had moderate mitral regurgitation due to a vegetation on the posterior mitral valve leaflet.
Observation:
- Ultrasound revealed splenic abscesses and intrauterine growth restriction with normal fetal vasculature.
- Fetal heart rate was normal at 140 bpm.
Findings:
- Delivery via Cesarean section at 33 weeks gestation was performed on day 11.
- The mother underwent successful mitral valve repair and tubal ligation post-delivery.
- Splenic abscesses were treated effectively with antibiotics.
Implications:
- This case demonstrates the successful management of infective endocarditis in pregnancy.
- A carefully timed, sequential approach to delivery and cardiac intervention is crucial for optimal maternal and fetal outcomes.
- This strategy can be a model for managing complex cardiac conditions during pregnancy.
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