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[Infective endocarditis associated with pregnancy]

S do C Jorge1, B I Mejia, M M Zamorano

  • 1Instituto Dante Pazzanese de Cardiologia, São Paulo.

Arquivos Brasileiros De Cardiologia
|April 1, 1995
PubMed
Summary

Infective endocarditis (IE) during pregnancy poses significant risks, with high maternal and fetal mortality, often linked to neurological complications. Puerperal IE had better outcomes without maternal deaths.

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Area of Science:

  • Cardiology
  • Obstetrics & Gynecology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) is a serious infection affecting heart valves.
  • Pregnancy and the postpartum period (puerperium) present unique challenges for managing IE.

Purpose of the Study:

  • To analyze the outcomes of infective endocarditis acquired during pregnancy and the puerperium.
  • To assess both intra-hospital and long-term follow-up results for these patients.

Main Methods:

  • A retrospective study of eleven patients with IE between 1984-1992.
  • Patients were categorized into two groups: IE during pregnancy (7 cases) and puerperal IE (4 cases).

Main Results:

  • In pregnant patients, IE predominantly affected the mitral valve (85%). Two required surgery, leading to one abortion and one fetal death post-cesarean due to maternal neurological complications.

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  • Maternal mortality in the pregnancy IE group was 47%.
  • In the puerperal IE group, valve involvement was mixed (mitral and aortic). Two patients underwent surgery for aortic regurgitation; however, no maternal deaths occurred in this group.

    • Conclusions:

    • Infective endocarditis during pregnancy is associated with high maternal and fetal morbidity and mortality.
    • Neurological complications in mothers significantly contributed to adverse outcomes during pregnancy-acquired IE.
    • Puerperal IE demonstrated a lower mortality rate compared to IE acquired during pregnancy.