FETAL AND OBSTETRICAL IMPACT OF PERCUTANEOUS BALLOON MITRAL COMMISSUROTOMY DURING PREGNANCY

Since 1984 percutaneous mitral balloon commissurotomy (PMC) has replac ed closed mitral commissurotomy in most of its indications. However th e application of this technique to pregnant women had raised considera ble concern essentially because of the risk of fetal distress and irra diation. Of 1,017 PMC performed between March 1986 and December 1992, 11 were carried out during pregnancy. At the time of the procedure ges tational time ranged from 24 to 34 weeks of amenorrhea. PMC resulted i n immediate hemodynamic improvement and there were no major maternal c omplications. Maternal abdominal radiation was always less than 0.2 mS v. Fetal heart rate was monitored during the procedure and showed only minor abnormalities. The outcomes of these 11 pregnancies were: 4 vag inal deliveries after 37 weeks, 5 cesarean sections after 37 weeks and 1 at 29 weeks. All newborn children were normotrophic and without mal formation.