Archives of the Turkish Society of Cardiology
Clinical and echocardiographic follow-up in pregnant patients with valvular heart disease [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2013; 41(1): 31-37 | DOI: 10.5543/tkda.2013.03295

Clinical and echocardiographic follow-up in pregnant patients with valvular heart disease

Hasan Ali Gümrükçüoğlu1, Ayşe Güler2, Dolunay Odabaşı3, Hakkı Şimşek1, Musa Şahin1, Serkan Akdağ1, Hekim Karapınar4, Aytaç Akyol1, Yılmaz Güneş1, Mustafa Tuncer1
1Department of Cardiology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
2Department of Obstetrics and Gynecology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
3Department of Cardiovascular Surgery Yuzuncu Yil University, Faculty of Medicine, Van, Turkey
4Department of Cardiology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey


OBJECTIVES
Pregnancy associated cardiovascular changes may result in a significant hemodynamic burden and can lead to morbidity and even mortality in women with cardiac disease. The present study aimed to evaluate clinical and echocardiographic follow-up in pregnant patients with valvular heart disease (VHD).
STUDY DESIGN
The medical records of pregnant patients diagnosed with VHD from January 2004 to January 2011 were screened. Demographic characteristics including history of cardiac intervention performed during pregnancy, pulmonary edema, and maternal and fetal mortality, and cesarean section (C/S) history were collected from the hospital database and clinical records of the cardiology and obstetrics departments. The echocardiographic examination was carried out at presentation, 3rd trimester, and 1 month after delivery. The outcomes evaluated were cardiac intervention, pulmonary edema, and both fetal and maternal mortality during pregnancy and C/S.
RESULTS
We evaluated the outcomes of 884 pregnant patients with VHD. Adverse clinical outcomes including death, pulmonary edema, and valvular interventions were frequent among patients with severe VHD, whereas no adverse clinical outcome was observed in patients with mild-moderate VHD (n=49, 5.5% vs. n=0, 0%, p<0.001). In patients with severe VHD, clinical outcomes were frequent among patients with valve stenosis, but lower among patients with regurgitation [death 4 (0.45%) vs. 0 (0%); pulmonary edema (15 (1.7%) vs. 13 (1.5%); valvular intervention 11 (1.2%) vs. 6 (0.7%); respectively).
CONCLUSION
Valvular heart disease is associated with fetal/ maternal morbidity and mortality. Pregnant with severe VHD constitute a high-risk group in which life-threatening complications are likely to occur in the course of pregnancy.

Keywords: Echocardiography, heart valve diseases; pregnancy; pregnancy complications, cardiovascular

How to cite this article
Hasan Ali Gümrükçüoğlu, Ayşe Güler, Dolunay Odabaşı, Hakkı Şimşek, Musa Şahin, Serkan Akdağ, Hekim Karapınar, Aytaç Akyol, Yılmaz Güneş, Mustafa Tuncer. Clinical and echocardiographic follow-up in pregnant patients with valvular heart disease. Turk Kardiyol Dern Ars. 2013; 41(1): 31-37

Corresponding Author: Hasan Ali Gümrükçüoğlu, Türkiye
Manuscript Language: English
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