Abstract
Cardiovascular diseases are one of the leading causes of maternal mortality. The management of pregnant women with mechanical valve prosthesis is difficult. Fetal-maternal mortality and morbidity are high. Selection of the most appropriate anticoagulant that will minimize fetal, maternal mortality and avoid embryopathy risk should be tailored according to the needs of each individual patient.
In this paper, in the light of the literature, we aimed to discuss our patient, who delivered at 39th gestational week after a pregnancy before which she had not been provided with prepregnancy counseling and during which she did not attend follow-up visits.
These patients prepregnancy counseling, follow-up visits, anticoagulant management during pregnancy, and prophylaxis and management of complications at the postpartum period are very important and require close follow-up.
Thanks
We would like to thank our gynecology and obstetrician and cardiologist colleagues who followed up the patient when she was referred to the tertiary center.
References
- Misra A, Porras MP, Rajendran A, et all. Cardio-Obstetrics: A Focused Review. Curr Cardiol Rep. 2023; 25(9):1065-73. (doi: 10.1007/s11886-023-01928-0)
- Otto CM, Nishimura RA, Bonow RO et all. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021; 143(5):e72-e227. (doi:10.1161/CIR.0000000000000923.)
- Siu SC, Colman JM, Sorensen S, et all. Adverse neonatal and cardiac outcomes are more common in pregnant women with cardiac disease. Circulation. 2002; 105(18):2179-84. (doi: 10.1161/01.cir.0000015699.48605.08)
- Vitale N, De Feo M, De Santo LS, Pollice A, Tedesco N, Cotrufo M. Dose-dependent fetal complications of warfarin in pregnant women with mechanicalheartvalves. J Am Coll Cardiol. 1999; 33:1637-41. (doi: 10.1016/s0735-1097(99)00044-3.)
- Küçüker A, Yapar EG, Küçüker ŞA et all. Mekanik Kalp Kapağı olan gebelerde klinik sonuçlar. Türk Göğüs Kalp Damar. 2014; 22(3):540-46.
- Grashuis P, Shanti D, Khargi M, et all. Pregnancy outcomes in women with mitral valveprosthesis: A systematicreview and Meta-Analysis. JTCVS Open. 2023; 9:14:102-22. (doi: 10.1016/j.xjon.2023.05.001.)
- Kovacs AH, Harrison JL, Colman JM et all. Pregnancy and contraception in congenital heart disease: what women are not told. J Am Coll Cardiol. 2008; 52(7):577-8. (doi: 10.1016/j.jacc.2008.05.013.)
- Martinez-Diaz JL. Valvular heart disease in pregnancy: a review of the literatüre. Bol Asoc Med P.R. 2008; 100(4):55-9.
- Heesen M, Carvalho B, Carvalho JCA, et al. International consensus statement on the use of uterotonic agents during caesarean section. Anaesthesia. 2019; 74(10):1305-19. (doi: 10.1111/anae.14757.)
- Jayasooriya G, Silversides C, Raghavan G et all. Anesthetic management of women with heart failure during pregnancy: a retrospective cohort study. Int J Obstet Anesth. 2020; 44:40-50. (doi: 10.1016/j.ijoa.2020.06.001.)
- Misoprostol: serious cardiovascular events, even after a single dose. Prescrire Int. 2015; 24(162):183-4.
- Matthesen T, Olsen RH, Bosselmann HS, Lidegaard Ø. [Cardiac arrest induced by vasospastic angina pectoris after vaginally administered misoprostol]. Ugeskr Laeger. 2017; 26:179.
- Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016; 124(2):270-300. (doi: 10.1097/ALN.0000000000000935.)
- Delgado V, Marsan NA, Waha S et all. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023; 14:44(39):3948-4042. (doi: 10.1093/eurheartj/ehad193)
Abstract
Kardiyovasküler hastalıklar anne ölümlerinin en önemli sebeplerindendir. Mekanik kapak protezi olan gebe hastalarda yönetim zordur. Fetal-maternal mortalite ve morbidite yüksektir. Fetal, maternal mortalite ve morbiditeyi en aza indirecek, embriyopati riski oluşturmayacak en uygun antikoagülan seçimi hastaya göre planlanmalıdır. Mekanik kapak protezi olan hastalarda gebelik öncesi danışmanlık, gebelik sürecinde takip ve antikoagülan yönetimi, postpartum dönemde de profilaksi ve komplikasyon yönetimi çok önemlidir, yakın takip gerektirir. Biz bu yazımızda gebelik öncesi danışmanlık almamış, gebelik süresinde de takiplere uyumu olmayan, otuz dokuzuncu gebelik haftasında doğumu yaptırılan olgumu literatür eşliğinde tartışmayı amaçladık.
References
- Misra A, Porras MP, Rajendran A, et all. Cardio-Obstetrics: A Focused Review. Curr Cardiol Rep. 2023; 25(9):1065-73. (doi: 10.1007/s11886-023-01928-0)
- Otto CM, Nishimura RA, Bonow RO et all. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021; 143(5):e72-e227. (doi:10.1161/CIR.0000000000000923.)
- Siu SC, Colman JM, Sorensen S, et all. Adverse neonatal and cardiac outcomes are more common in pregnant women with cardiac disease. Circulation. 2002; 105(18):2179-84. (doi: 10.1161/01.cir.0000015699.48605.08)
- Vitale N, De Feo M, De Santo LS, Pollice A, Tedesco N, Cotrufo M. Dose-dependent fetal complications of warfarin in pregnant women with mechanicalheartvalves. J Am Coll Cardiol. 1999; 33:1637-41. (doi: 10.1016/s0735-1097(99)00044-3.)
- Küçüker A, Yapar EG, Küçüker ŞA et all. Mekanik Kalp Kapağı olan gebelerde klinik sonuçlar. Türk Göğüs Kalp Damar. 2014; 22(3):540-46.
- Grashuis P, Shanti D, Khargi M, et all. Pregnancy outcomes in women with mitral valveprosthesis: A systematicreview and Meta-Analysis. JTCVS Open. 2023; 9:14:102-22. (doi: 10.1016/j.xjon.2023.05.001.)
- Kovacs AH, Harrison JL, Colman JM et all. Pregnancy and contraception in congenital heart disease: what women are not told. J Am Coll Cardiol. 2008; 52(7):577-8. (doi: 10.1016/j.jacc.2008.05.013.)
- Martinez-Diaz JL. Valvular heart disease in pregnancy: a review of the literatüre. Bol Asoc Med P.R. 2008; 100(4):55-9.
- Heesen M, Carvalho B, Carvalho JCA, et al. International consensus statement on the use of uterotonic agents during caesarean section. Anaesthesia. 2019; 74(10):1305-19. (doi: 10.1111/anae.14757.)
- Jayasooriya G, Silversides C, Raghavan G et all. Anesthetic management of women with heart failure during pregnancy: a retrospective cohort study. Int J Obstet Anesth. 2020; 44:40-50. (doi: 10.1016/j.ijoa.2020.06.001.)
- Misoprostol: serious cardiovascular events, even after a single dose. Prescrire Int. 2015; 24(162):183-4.
- Matthesen T, Olsen RH, Bosselmann HS, Lidegaard Ø. [Cardiac arrest induced by vasospastic angina pectoris after vaginally administered misoprostol]. Ugeskr Laeger. 2017; 26:179.
- Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016; 124(2):270-300. (doi: 10.1097/ALN.0000000000000935.)
- Delgado V, Marsan NA, Waha S et all. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023; 14:44(39):3948-4042. (doi: 10.1093/eurheartj/ehad193)
Details
| Primary Language | English |
|---|---|
| Subjects | Obstetrics and Gynaecology |
| Journal Section | Case Report |
| Authors | |
| Early Pub Date | April 17, 2024 |
| Publication Date | April 30, 2024 |
| Submission Date | October 16, 2023 |
| Acceptance Date | February 14, 2024 |
| Published in Issue | Year 2024 Volume: 13 Issue: 1 |
