Immediate and Long-Term Follow-Up of Percutaneous Mitral Commisurotomy in Pregnant Women with Rheumatic Mitral Stenosis: About 246 Cases

Methods: A retrospective study of 246 mitral valve dilations performed during pregnancy from 1997 to 2018 in the Cardiology A department, Ibn Sina Teaching hospital Rabat. We analyzed the obstetric outcome and childhood development, mean follow up period was 10 5.5 years (range 1-17 years). Results: MBV was successful in all patients with improvement in their NYHA class to I/II. All patients underwent obstetrical examination and follow-up, including abdominal and pelvic ultrasound san before and after the intervention. After MBV, patients underwent regular materno-fetal check-up. Labor spontaneously began at 38 1 week of amenorrhea; 85% of our patient had vaginal birth whilst 15% went through cesarean section for obstetrical reasons. After MBV, pregnancy reached full term in 95% of the cases with a low fetal morbimortality. The long-term follow-up of dilated patients stretched between a period of 5 to 17 years. Within the period of 44 39 months, event rate (death, surgery or redilation) was 10%. In our series the results of BMV during pregnancy were maintained at long term and were superposable to those of non-pregnant dilated patients. Long term follow-up of children born after MBV during pregnancy stretched up to 4 years and showed growth and intellectual development comparable to children of the same age, with a consequent 17-year retrospect showing equivalent results and absence of radiology-induced pathologies thus confirming the innocuousness of MBV during pregnancy. Conclusion: Mitral Balloon Valvuloplasty is a safe and useful procedure during pregnancy, with no short or long term adverse affects on the mothers and their obstetric future. The children born of subsequent pregnancies exhibited normal physical and mental development.