[Pregnancy, labor and puerperal problems of women with acquired heart defects]

A total of 592 women in child-birth, at an average age between 15 and 42, mean 26.8 +/- 8.4 years, have been studied. The women with mitral valve defects predominate--83.9% (mitral stenosis--39.8%, mitral insufficiency--18.5% and combined mitral stenosis and insufficiency--41.7%), followed by the women with combined) aorto-mitral defects--9.8% and those with isolated aortic defects--6.3% (out of them with aortic stenosis 35.1%), aortic insufficiency--43.2% and combined aortic defect 21.7%). Pulmonary hypertension proved to have 83 women (14%), all with mitral and mitral-aortic defects. Cardiac insufficiency was established in 130 patients (22%-53.8%, stage I, 38.5%, stage II A and 7.7%--stage II B). Cardiac complications during pregnancy were observed in 29.6% of the patients, during delivery--in 5.4 and in puerperium--in 7.4%. Three women have died--one during delivery and two--during the early puerperal period. The percentage of the women that have given birth by via naturalis is 81.6% and the women that needed assistance--18.4%. A total of 587 viable children have been born (7 twins), 9--non-viable and 3--stillborn. A proper evaluation, in advance, of the cardiac affection and adequate behaviour during pregnancy and labour are necessary for the successful outcome of the pregnancy and delivery in females with valvular heart defects.