Valvular Heart Disease in Pregnancy

Cardiol Clin. 2021 Feb;39(1):151-161. doi: 10.1016/j.ccl.2020.09.010. Epub 2020 Nov 2.

Abstract

Valvular heart disease (VHD) is generally well tolerated during pregnancy; however, the dramatic changes in hemodynamics that occur during pregnancy can lead to clinical decompensation in high-risk women. Women with VHD considering pregnancy should undergo preconception counseling with a high-risk obstetrician and cardiologist to review the maternal, fetal, and obstetric risks of pregnancy and delivery. Vaginal delivery is recommended for most women with VHD. Given the complexity of managing VHD during pregnancy, women should be managed by a multidisciplinary Pregnancy Heart Team during pregnancy, consisting of a high-risk obstetrician, cardiologist, and cardiac anesthesiologist.

Keywords: Anticoagulation; Aortic stenosis; Mechanical heart valve; Mitral stenosis; Pregnancy; Valvular heart disease.

Publication types

  • Review

MeSH terms

  • Female
  • Heart Failure / prevention & control*
  • Heart Valve Diseases* / diagnosis
  • Heart Valve Diseases* / physiopathology
  • Heart Valve Diseases* / therapy
  • Hemodynamics
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular* / diagnosis
  • Pregnancy Complications, Cardiovascular* / physiopathology
  • Pregnancy Complications, Cardiovascular* / therapy
  • Prognosis
  • Risk Adjustment / methods*
  • Risk Assessment