Key result
Vaginal delivery succeeds without complications in asymptomatic severe AS with preserved LVEF.
Why the study?
Severe aortic stenosis is a high-risk condition in pregnancy, and there is no consensus on the mode of delivery in patients with asymptomatic severe aortic stenosis.
Is vaginal delivery a viable option in pregnant patients with asymptomatic severe aortic stenosis?
Case Report (n=1)
No
Is vaginal delivery a viable option in pregnant patients with asymptomatic severe aortic stenosis?
Vaginal delivery may be a viable option for pregnant women with asymptomatic severe aortic stenosis and preserved ejection fraction when continuous haemodynamic monitoring is available.
Highlights need for individualized care in pregnant women with severe AS; leaves open consensus on asymptomatic case management.
Heart disease complicates about 1-4% of all pregnancies of which valvular heart disease is the commonest cause. In developing countries, congenital heart diseases are commonly first detected during pregnancy. Most women do well during pregnancy but severe mitral stenosis or severe aortic stenosis are high-risk conditions that can cause significant morbidity and mortality. Unlike asymptomatic severe mitral stenosis, asymptomatic severe aortic stenosis is mWHO category 3. There is no consensus on the mode of delivery in patients with asymptomatic severe aortic stenosis. Here we describe a case of successful vaginal delivery in a woman with severe aortic stenosis. As the patient was asymptomatic and ejection fraction was preserved, a joint decision for vaginal delivery was taken along with the cardiology team. The patient was induced and delivered with operative vaginal delivery. This case shows that vaginal delivery could be a viable option in patients with asymptomatic severe aortic stenosis given continuous haemodynamic monitoring can be provided.
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Kanagavarshani et al. (2023) conducted a case report in Asymptomatic severe aortic stenosis in pregnancy (n=1). Vaginal delivery was evaluated on Maternal and fetal outcomes following vaginal delivery. Vaginal delivery was successfully performed without maternal or fetal complications in a 26-year-old woman with asymptomatic severe aortic stenosis and preserved ejection fraction.
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