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Valvular Heart Disease in Pregnancy
Jennifer Lewey1, Lauren Andrade2, Lisa D Levine3
1Division of Cardiology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, 2-East Pavilion, Philadelphia, PA 19104, USA.
Cardiology Clinics
|November 23, 2020
Summary
Pregnancy with valvular heart disease (VHD) requires careful management. High-risk women need preconception counseling and a multidisciplinary team for optimal outcomes during pregnancy and delivery.
Area of Science:
- Cardiology
- Obstetrics
- Maternal-Fetal Medicine
Background:
- Valvular heart disease (VHD) presents unique challenges during pregnancy due to significant hemodynamic alterations.
- While often well-tolerated, VHD can lead to clinical decompensation in high-risk pregnancies.
Purpose of the Study:
- To outline the essential considerations for managing pregnant women with valvular heart disease.
- To emphasize the importance of preconception counseling and multidisciplinary care.
Main Methods:
- Review of current guidelines and clinical practice for VHD in pregnancy.
- Emphasis on preconception counseling, risk assessment, and delivery recommendations.
- Highlighting the role of a specialized Pregnancy Heart Team.
Main Results:
- Preconception counseling is crucial for assessing maternal, fetal, and obstetric risks.
- Vaginal delivery is generally recommended for most women with VHD.
- Multidisciplinary management by a Pregnancy Heart Team is vital.
Conclusions:
- Pregnancy in women with VHD necessitates comprehensive preconception planning and ongoing specialized care.
- A collaborative approach involving high-risk obstetricians, cardiologists, and cardiac anesthesiologists ensures optimal maternal and fetal outcomes.
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