PREGNANCY FOLLOWING CARDIAC PROSTHETIC VALVE-REPLACEMENT

Objective: To determine the effect of cardiac valve replacement on pre gnancy outcome. Methods: We reviewed retrospectively 151 pregnancies i n 88 women: 56 pregnancies in 31 women with mechanical valves and anti coagulation therapy, and 95 pregnancies in 57 women with porcine tissu e valves. Student t, chi(2), and Fisher exact tests were used for anal ysis. Results: There was a significantly greater rate of fetal loss in patients with mechanical valve replacements than in those with porcin e tissue valves (27.7 versus 12.3%, respectively; P < .05). No signifi cant differences were found in prematurity (5.9 versus 7.7%) or small for dates infants (8.8 versus 10.8%). Two congenital anomalies were no ted in the mechanical valve group. Maternal complications in patients with mechanical valves included valve dysfunction (three), thromboembo lism (three), abruptio placentae (two), postpartum hemorrhage (two), s evere oligohydramnios (two), and puerperal fever caused by brain absce ss (one). Four cases of valve dysfunction and one of infectious endoca rditis complicated the condition of patients with porcine tissue valve s. The 10-year graft survival rate in the porcine valve group was lowe r following two subsequent pregnancies (16.7%) than following one (54. 8%). Conclusion: Fewer fetal and maternal complications occurred in su bsequent pregnancies after porcine valve replacement. However, the nee d for reoperation is more likely, and pregnancy might accelerate the d egenerative process.