The Effect of Mitral Stenosis on Maternal and Fetal Outcome in Pregnancy

Objectives: The aim of the study was evaluate maternal and fetal outcomes of mitral stenosis at pregnant women. Methods: Forty-one pregnant woman with moderate and severe mitral stenosis were enrolled in the study. Predictor variables were the apgar score, new born weight and delivery week. Progression of NYHA functional class, thromboembolism, death, new onset atrial fibrillation was accepted as maternal event. Abortion, fetal or neonatal death, prematurity or low birth weight were accepted as fetal events. Results: In newborn babies, 10 were followed-up in intensive care. The mothers of these infants had higher LA diameters, their MVA’s were smaller and the pulmonary hypertension was higher.It was observed that the LA diameter and warfarin treatment were independent risk factors for the need for intensive care. The NYHA was primarily dependent from the LA diameter, followed by the MVA, mean difference in the pressure and the pulmonary artery pressure (PAP).The independent risk factors of the birth weight and the 1st min. and 5th min. Apgar scores, only the LA diameter was found as significant. Also, the independent risk factors of the gestational age at birth are the NYHA classification and the MVA. Warfarin treatment in the mother has also been observed as a risk factor for IUGR. Conclusion: These results reveal that especially patients with mitral stenosis should be closelymonitored throughout their pregnancy.