Key result
Peripartum cardiac interventions, including balloon valvuloplasty and double valve replacement combined with cesarean delivery, achieved favorable maternal and fetal outcomes in two women with severe valvular heart disease.
Why the study?
Cardiac interventions during advanced gestation carry risks of maternal complications and mortality alongside threats to fetal life, but can be performed successfully peripartum with modern techniques.
Case Report (n=2)
Peripartum cardiac interventions, including balloon valvuloplasty or valve replacement, can be successfully performed alongside cesarean delivery in pregnant women with severe decompensated valvular heart disease to achieve favorable maternal and fetal outcomes.
Answers are grounded in this paper and cite their sources.
Case reports suggest peripartum valvular interventions are feasible; leaves open need for prospective data before practice change.
Cardiac interventions during advanced gestation carry a risk of maternal complications including mortality, along with the serious threat to the life of a viable fetus. However, with advancements in anesthesia and surgery techniques, cardiac interventions can be performed successfully during the peripartum period. We report two cases of decompensated severe valvular stenosis in the third trimester. One patient underwent balloon valvuloplasty followed by cesarean delivery. However, the other underwent a cesarean delivery followed by double valve replacement. Favorable maternal and fetal outcomes were achieved through peripartum interventions. Good fetomaternal outcomes can be obtained in women with severe valvular heart disease (VHD) presenting late in pregnancy. The decision for the timing of cardiac intervention in relation to cesarean section (CS) can vary from case-to-case basis.
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Deedwania et al. (2022) conducted a case report in Severe valvular heart disease in advanced pregnancy (n=2). Peripartum cardiac intervention (balloon valvuloplasty or double valve replacement) with cesarean delivery was evaluated on Maternal and fetal outcomes. Peripartum cardiac interventions, including balloon valvuloplasty and double valve replacement combined with cesarean delivery, achieved favorable maternal and fetal outcomes in two women with severe valvular heart disease.
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