[Cardiotocology and metallic valve prostheses].
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Biomedical subjects
Publications and source records attributed to W S Avila.
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The benefits of surgical treatment for patients with congenital heart disease in relation to pregnancy are still controversial. We studied 48 pregnant women (mean age = 25 years) with surgically-corrected congenital heart diseases (Group 1). This included 15 cyanotic diseases: Fallot's tetralogy (11 cases); Ebstein's anomaly (2 cases); transposition of the great arteries (1 case); and double outlet of the right ventricle (1 case). We compared them to 52 pregnant women (mean age = 26 years) with untreated congenital heart diseases, which included 11 cases of Eisenmenger's syndrome (Group 2). Group 2 showed a higher incidence of maternal death (12 vs. 0 percent; p = 0.01), perinatal mortality (15 vs. 0 percent; p = 0.01) and prematurity (32 vs. 7 percent; p = 0.01). Spontaneous abortion (4 vs. 10 percent), Caesarean deliveries (48 vs. 66 percent) or growth retardation (13 vs. 28 percent) did not present any significant differences between these groups. Surgical treatment in patients with heart diseases is associated with a better maternal and fetal prognosis. Therefore, surgery must be considered when counseling patients with congenital heart diseases.
PURPOSE: To study pregnancy, delivery, puerperium and the newborn in cases of mitral valve stenosis, asymptomatic at conception. METHOD: Sixty-two pregnant women, 30 with mitral valve stenosis (GE group) and 32 without cardiac disease (GN group) had their functional class, kind of delivery, anesthetic technique and newborn characteristics evaluated during gestation. RESULTS: In GE group 16 (53.3%) patients changed from functional class (FC) I/II to FC III and 10 (33.3%) to FC IV. In GN group 18 (56.2%) changed from FC I to II during the gestation. Delivery was vaginal in 21 patients (70%); anesthetic technique was regional block in 17 (56.6%). These findings were not statistically different between (p > 0.1) the groups. Premature (20.0%) and small babies for gestational age (36.7%) were higher (p > 0.001) in GE group. There were no cases of maternal death. CONCLUSION: The majority of GE women who started pregnancy in FC I/II changed to FC III/IV during gestation. Probably adequate medical treatment and valvoplasty in one case allowed fetal viability; but we had higher incidence of pre-term and small for gestation age babies in the GE group.