Prognostic factors of rheumatic mitral stenosis during pregnancy and puerperium

Autor: Paulo José Bastos Barbosa, Antônio Alberto Lopes, Gilson Soares Feitosa, Rosângela Vasconcelos de Almeida, Rosenbert Mamédio da Silva, José Carlos Brito, Maria Lúcia Duarte, Augusto José Gonçalves Almeida
Jazyk: English<br />Portuguese
Rok vydání: 2000
Předmět:
Zdroj: Arquivos Brasileiros de Cardiologia, Vol 75, Iss 3, Pp 220-224 (2000)
Druh dokumentu: article
ISSN: 0066-782X
1678-4170
DOI: 10.1590/S0066-782X2000000900003
Popis: OBJECTIVE: To identifity characteristics associated with complications during pregnancy and puerperium in patients with rheumatic mitral stenosis. METHODS: Forty-one pregnant women (forty-five pregnancies) with mitral stenosis, followed-up from 1991 to 1999 were retrospectively evaluated. Predictor variables: the mitral valve area (MVA), measured by echocardiogram, and functional class (FC) before pregnancy (NYHA criteria).Maternal events: progression of heart failure, need for cardiac surgery or balloon mitral valvulotomy, death, and thromboembolism. Fetal/neonatal events: abortion, fetal or neonatal death, prematurity or low birth weight ( or = II and III versus I) was also associated with a risk for maternal events (RR=2.7; 95% CI=1.4-5.3).MVA and FC were not importantly associated with these events, although a smaller frequency of fetal/neonatal events was observed in patients who had undergone balloon valvulotomy. CONCLUSION: In pregnant women with mitral stenosis, the MVA and the FC are strongly associated with maternal complications but are not associated with fetal/neonatal events. Balloon mitral valvulotomy could have contributed to reducing the risks of fetal/neonatal events in the more symptomatic patients who had to undergo this procedure during pregnancy.
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