The valve patient and pregnancy

Pregnancy causes a significant and sustained increase in cardiac output that may be poorly tolerated in cases of underlying heart disease. Valvular stenosis is often poorly tolerated and may require intervention during pregnancy, percutaneous intervention being the favored option. Conversely, regurgitant valve diseases are generally well-tolerated. Pregnancy in patients who have previously undergone prosthetic valve replacement raises specific problems linked to anticoagulant therapy. The choice is difficult between oral anticoagulation, which carries a risk of embryopathy, and heparin therapy, which is safer for the fetus but is associated with a high thromboembolic risk for the mother. The diversity of cases highlights the need for appropriate evaluation of heart disease before pregnancy and close follow-up by specialized teams.