Valvular heart disease in pregnancy

Best Pract Res Clin Obstet Gynaecol. 2014 May;28(4):507-18. doi: 10.1016/j.bpobgyn.2014.03.009. Epub 2014 Apr 3.

Abstract

In women with valvular heart disease, pregnancy-associated cardiovascular changes can contribute to maternal, foetal and neonatal complications. Ideally, a woman with valvular heart disease should receive preconception assessment and counselling from a cardiologist with expertise in pregnancy. For women with moderate- and high-risk valve lesions, appropriate risk stratification and management during pregnancy will optimise outcomes. Pregnancy in women with high-risk lesions, such as severe aortic stenosis, severe mitral stenosis and those with mechanical valves, requires careful planning and coordination of antenatal care by a multidisciplinary team. The purpose of this overview is to describe the expected haemodynamic changes in pregnancy, review pregnancy risks for women with valvular heart disease and discuss strategies for management.

Keywords: aortic stenosis; mechanical valve; mitral stenosis; pregnancy; prosthetic valve; valvular heart disease.

Publication types

  • Review

MeSH terms

  • Female
  • Heart Valve Diseases / physiopathology*
  • Heart Valve Diseases / therapy*
  • Heart Valve Prosthesis
  • Humans
  • Preconception Care
  • Pregnancy / physiology
  • Pregnancy Complications, Cardiovascular / physiopathology*
  • Pregnancy Complications, Cardiovascular / therapy*
  • Prenatal Care*