Pregnancy in association with mitral valve prolapse

Mitral valve prolapse (MVP) is considered to be the most common valvular heart lesion in adult females of reproductive age. Our report reviews the obstetrical performance and outcome of 34 pregnancies in 15 women with MVP. In 12 (80%) patients cardiac lesion was suspected due to enigmatic dyspnoea and palpitation during antenatal period. Four mothers required propranolol for cardiac arrhythmias. However, all of them tolerated pregnancy and labour well. Four pregnancies (11.8%) ended in spontaneous abortion and 1 mother had intrauterine fetal death due to severe pregnancy-induced hypertension. There were 25 (73.5%) term and 3 (8.8%) preterm neonates without congenital abnormality. One preterm neonate had tracheo-oesophageal fistula and died 6 hours after corrective surgery. The mean birth weight of 2.8 kg was appropriate for mean gestation of 38.5 weeks when compared to the Institute's reference neonatal weight curve. Infective endocarditis prophylaxis was recommended in cases having mitral regurgitation and complicated delivery. Awareness of this common cardiac lesion, thorough cardiovascular examination during pregnancy, early detection and treatment of cardiac arrhythmias if any, are the essential steps to prevent rare but dreaded maternal complications.