Maternal and fetal risk of pregnancy in cardiac patients with and without anticoagulant treatment
Braun, S.; Roberts, A.; Chamorro, G.; Leontic, E.; Casanegra, P.; Albuquerque, J.
Revista Medica de Chile 112(10): 1009-1016
1984
ISSN/ISBN: 0034-9887 PMID: 6536075 Document Number: 5485
The medical records of all pregnant women with heart disease admitted to the Catholic University Hospital Maternity from March 1982 through October 1984 were reviewed; 1 73 pregnancies in 128 patients with rheumatic valvular heart disease were compared to 193 pregnancies in 111 patients without heart disease. Seventeen pregnancies in patients with congenital heart disease and 3 with miscellaneous cardiopathies were excluded. Of the 173 pregnancies with valvular disease, 101 had mitral valve disease, 15 aortic, 28 mitro-aortic, and 29 at least one prosthetic valve replacement. Their functional capacity prior to pregnancy was I or II in 98%; 24 patients were on oral anticoagulants.,4 greater number (p<0.05) of abortions and premature deliveries were observed in the valvular heart disease group when compared to controls (11% vs 4% and 16% vs 6% respectively). The incidence of abortion was even greater in the anticoagulant group (24% p<0.01). Only 14 patients developed heart failure, 11 of them with mitral stenosis. One mother died of prosthetic valve thrombosis. Pregnancy in patients with heart disease in good functional capacity carries a low maternal risk. The incidence of abortions is greater in patients with valvular heart disease specially if on oral anticoagulants.
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