Pregnancy following cardiac valve replacement surgery

Objectives: To study the outcome of pregnancy in women with artificial hear t valves and to compare the maternal and perinatal outcome in mechanical an d bioprosthetic valves. Method: Retrospective analysis of 34 pregnancies in 29 women who conceived after cardiac valve replacement was carried out. Re sults: The majority of women (76.4%) delivered within 5 years of valve repl acement. Anticoagulants were administered in 79.4% of pregnancies. Maternal mortality was 2.9% and maternal morbidity in the form of heart failure, at rial fibrillation, valve thrombosis, thromboembolism, bleeding complication s and non-functioning prostheses were 2.9%, 5.8%, 2.9%, 2.9%, 11.7% and 2.9 %, respectively. The incidence of prematurity was 5.8% and small for gestat ional age babies was 11.7%. There was no case of abortion. Two babies (5.8% ) were still born, one of which had malformations. Maternal complications w ere significantly higher in women with bioprostheses, though the complicati ons were more grave in the mechanical prostheses group. The perinatal outco me was almost similar in both the groups. Conclusion: The perinatal outcome was not different in women with bioprosthetic valves from the ones with me chanical prostheses, but the maternal morbidity was more in women with biop rosthetic valves. Coumarin derivatives were safe and effective and did not lead to embryopathy. (C) 1999 International Federation of Gynecology and Ob stetrics.