Mitral Stenosis During Pregnancy

From Ask Dr Wiki

Overview

• Most hemodynamically important valvular problem during pregnancy
• Physiologic changes result in increased HR and C.O. with augmentation of diastolic gradient
• Atrial fibrillation can lead to rapid deterioration
• Volume shifts during delivery can result in pulmonary HTN/pulmonary edema

Management of MS in Pregnancy

• Restriction of physical activity and salt intake. Avoid supine position
• Beta-blockade to lengthen DFP
• Diuretics if necessary (gentle)
• Consideration of invasive monitoring
• Replace blood losses during delivery carefully
• PBMVC can be performed during pregnancy if necessary (Class III,IV)