Women with valvular heart disease require specialized, multi-disciplinary care before, during, and after pregnancy to optimize maternal and fetal outcomes.
May support multidisciplinary pregnancy pathways in valvular heart disease; extends reviews yet leaves optimal protocols open to prospective validation.
Patients with valvular disease who desire pregnancy or are already pregnant require specialised care. Ideally, women undergo preconceptual counselling that addresses any procedures needed to decrease the risks of pregnancy, including valve replacement, if the patient has symptoms at baseline. Management during pregnancy includes replacing any contraindicated medications with safer alternatives, optimising loading conditions, careful monitoring and aggressive treatment of any exacerbating factors. Rarely, percutaneous or surgical intervention is required during pregnancy. Labour and delivery often require invasive haemodynamic monitoring and a multi-disciplinary team for optimal maternal and fetal outcomes.
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Stout et al. (2006) studied this question.
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