β-Adrenergic receptor blockade in the management of pregnant women with mitral stenosis

Kasab, Saad M. Al; Sabag, Taher; Zaibag, Muayed Al; Awaad, M; Bitar, Issam Al; Halim, Murtada; Abdullah, Moheeb; Shahed, Mona Al; Rajendran, V.; Sawyer, W. A.

doi:10.1016/s0002-9378(11)90661-9

Cited by 91 publications

(20 citation statements)

References 7 publications

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“…The results shown are consistent with those reported by other authors 6,9,14 . The association of the prepregnancy functional class with the risk of maternal events draws the attention to the possibility of reducing these complications in pregnant women with mitral stenosis by means of early interventions aimed at improving their functional class.…”

Section: Discussionsupporting

confidence: 94%

Prognostic factors of rheumatic mitral stenosis during pregnancy and puerperium

Barbosa¹,

Lopes

Feitosa

et al. 2000

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 94%

Prognostic factors of rheumatic mitral stenosis during pregnancy and puerperium

Barbosa¹,

Lopes

Feitosa

et al. 2000

Arq. Bras. Cardiol.

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“…β-blockers control the increase in heart rate and corrects the symptoms by extending the diastolic filling time (11)(12)(13) . In the pregnant women with atrial flutter and fibrillation, procainamide (14) .…”

Section: Follow-up Of the Pregnant Women With Valvular Diseasementioning

confidence: 99%

Valvular Diseases in Pregnancy

Parlakgumus¹,

Bağış²,

Haydardedeoğlu³

2011

J Turk Soc Obstet Gynecol

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“…9,10 In a study of 25 pregnant women with symptomatic, moderate to severe mitral stenosis (MVA ¼ 1.1 cm 2 ), treatment with beta-blockers resulted in improvement in or stabilization of NYHA functional class to II in 92%. 11 Chronic diuretics should be used with caution to avoid hypoperfusion of the placenta, but they have been used successfully in women with acute pulmonary oedema due to peripartum cardiomyopathy and mitral stenosis without adverse risk to the fetus. 12 Sodium restriction and modest fluid restriction should be recommended in symptomatic women.…”

Section: Medical Managementmentioning

confidence: 99%

Mitral valve disease in pregnancy: outcomes and management

Tsiaras

Poppas

2009

Obstet Med

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Summary: Young women may have asymptomatic mitral valve disease which becomes unmasked during the haemodynamic stress of pregnancy. Rheumatic mitral stenosis is the most common cardiac disease found in women during pregnancy. The typical increased volume and heart rate of pregnancy are not well tolerated in patients with more than mild stenosis. Maternal complications of atrial fibrillation and congestive heart failure can occur, and are increased in patients with poor functional class and severe pulmonary artery hypertension. Patients can be diagnosed by echocardiography and symptoms treated with beta-1 antagonists and cautious diuresis. Patients with heart failure unresponsive to treatment can undergo percutaneous balloon mitral valvuloplasty. Labour and delivery goals include reducing tachycardia by adequate pain control and minimized volume shifts. Mitral valve regurgitation, even when severe, is usually very well tolerated in pregnancy as the increase in volume is offset by a decrease in vascular resistance. On the other hand, patients with left ventricular dysfunction, moderate pulmonary hypertension or NYHA functional class III-IV are at increased risk for heart failure and arrhythmias. They may need cautious diuresis and limitations on physical activity during pregnancy, as well as invasive haemodynamic monitoring for labour and delivery. Vaginal delivery is preferred and caesarean section reserved for obstetric indications.

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β-Adrenergic receptor blockade in the management of pregnant women with mitral stenosis

Cited by 91 publications

References 7 publications

Prognostic factors of rheumatic mitral stenosis during pregnancy and puerperium

Prognostic factors of rheumatic mitral stenosis during pregnancy and puerperium

Valvular Diseases in Pregnancy

Mitral valve disease in pregnancy: outcomes and management

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